Consensus validation of a screening tool for cardiovascular pharmacotherapy in geriatric patients: the RASP_CARDIO list (Rationalization of Home Medication by an Adjusted STOPP list in Older Patients)

Schutter, Hannah De; Hias, Julie; Hellemans, Laura; Walgraeve, Karolien; Tournoy, Jos; Verhamme, Peter; Sinnaeve, Peter; Willems, Rik; Droogné, Walter; Vandenbriele, Christophe; Aelst, Lucas Van; Vanassche, Thomas; Linden, Lorenz Van der

doi:10.1007/s41999-022-00701-w

Cited by 3 publications

(1 citation statement)

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“…A screening tool for cardiovascular pharmacotherapy in geriatric patients (RASP_CARDIO list) states that triple therapy (dual antiplatelet therapy and one anticoagulant) longer than 1 month after a percutaneous coronary intervention is potentially inappropriate. Treatment duration is preferably limited to 1 week (with mostly stepping down to dual antithrombotic therapy upon discharge from the hospital) ( De Schutter et al, 2022 ). For patients taking two antithrombotic agents, starting or continuing a proton pump inhibitor and avoiding NSAIDs should be employed to reduce gastrointestinal bleeding risk.…”

Section: Discussionmentioning

confidence: 99%

Potentially clinically significant drug-drug interactions in older patients admitted to the hospital: A cross-sectional study

Maříková

Vlček

2023

Front. Pharmacol.

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Background: An international consensus list of potentially clinically significant drug-drug interactions (DDIs) in older people has been recently validated. Our objective was to describe the prevalence and characteristics of drug combinations potentially causing clinically significant DDIs identified in the medication history of older patients admitted to the hospital and the prevalence and characteristics of manifest DDIs–DDIs involved in adverse drug events present at hospital admission, DDIs that contributed to ADE-related hospital admissions, and DDIs involved in drug-related laboratory deviations.Methods: The data were obtained from our previous study that examined the drug-relatedness of hospital admissions to University Hospital Hradec Králové via the department of emergency medicine in the Czech Republic. Patients ≥ 65 years old were included. Drug combinations potentially causing clinically significant DDIs were identified using the international consensus list of potentially clinically significant DDIs in older people.Results: Of the 812 older patients admitted to the hospital, 46% were exposed to drug combinations potentially causing clinically significant DDIs. A combination of medications that affect potassium concentrations accounted for 47% of all drug combinations potentially causing clinically significant DDIs. In 27 cases, potentially clinically significant DDIs were associated with drug-related hospital admissions. In 4 cases, potentially clinically significant DDIs were associated with ADEs that were present at admissions. In 4 cases, the potentially clinically significant DDIs were associated with laboratory deviations. Manifest DDIs that contributed to drug-related hospital admissions most frequently involved antithrombotic agents and central nervous system depressants.Conclusion: The results confirm the findings from the European OPERAM trial, which found that drug combinations potentially causing clinically significant DDIs are very common in older patients. Manifest DDIs were present in 4.3% of older patients admitted to the hospital. In 3.3%, manifest DDIs contributed to drug-related hospital admissions. The difference in the rates of potential and manifest DDIs suggests that if a computerized decision support system is used for alerting potentially clinically significant DDIs in older patients, it needs to be contextualized (e.g., take concomitant medications, doses of medications, laboratory values, and patients’ comorbidities into account).

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Section: Discussionmentioning

confidence: 99%