1. Assessing Potentially Inappropriate Prescribing in Community-Dwelling Older Patients Using the Updated Version of STOPP-START Criteria: A Comparison of Profiles and Prevalences with Respect to the Original Version
- Author
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Inmaculada Bellido-Estevez, Maria Rosa García-Merino, Lorena Aguilar-Cano, Ricardo Ocaña-Riola, Jennifer Valdellós, Gabriel Ariza-Zafra, Encarnación Blanco-Reina, [Blanco-Reina, Encarnacion] Univ Malaga, Malaga Biomed Inst IBIMA, Sch Med, Dept Pharmacol & Therapeut, Malaga, Spain, [Bellido-Estevez, Inmaculada] Univ Malaga, Malaga Biomed Inst IBIMA, Sch Med, Dept Pharmacol & Therapeut, Malaga, Spain, [Garcia-Merino, Maria Rosa] Hlth Dist Cordoba Sur, Cordoba, Spain, [Ocana-Riola, Ricardo] Andalusian Sch Publ Hlth, Dept Stat, Granada, Spain, [Aguilar-Cano, Lorena] Hlth Dist Malaga, Malaga, Spain, [Valdellos, Jennifer] Hlth Area Malaga Norte, Malaga, Spain, [Ariza-Zafra, Gabriel] Univ Hosp Albacete, Dept Geriatr, Albacete, Spain, Fundacion Publica Andaluza Progreso y Salud, Consejena de Salud, Junta de Andalucia, [Blanco-Reina,E, Bellido-Estévez,I] Pharmacology and Therapeutics Department, Medical School, Málaga Biomedical Institute (IBIMA), University of Málaga, Málaga, Spain. [García-Merino,MR] Health District of Córdoba Sur, Córdoba, Spain. [Ocaña-Riola,R] Statistics Department, Andalusian School of Public Health, Granada, Spain. [Aguilar-Cano,L] Health District of Málaga, Málaga, Spain. [Valdellós,J] Health Area of Málaga Norte, Málaga, Spain. [Ariza-Zafra,G] Geriatrics Department, University Hospital of Albacete, Albacete, Spain., and This research has been supported by public grant funding provided by the Fundación Pública Andaluza Progreso y Salud, Consejería de Salud, Junta de Andalucía (grant number PI 0234/14).
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Male ,Pediatrics ,Potentially Inappropriate Medication List ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Polypharmacy [Medical Subject Headings] ,Cross-sectional study ,Prevalence ,lcsh:Medicine ,Inappropriate Prescribing ,Screening tool ,Cardiovascular Medicine ,030226 pharmacology & pharmacy ,Geriatric Depression ,Primary-care ,Elderly ,Endocrinology ,0302 clinical medicine ,Risk Factors ,Prescripciones de medicamentos ,Sleep Initiation and Maintenance Disorders ,Medicine and Health Sciences ,Clinical endpoint ,Medicine ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [Medical Subject Headings] ,lcsh:Science ,Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings] ,Aged, 80 and over ,Geriatrics ,Prescripción inadecuada ,Multidisciplinary ,Depression ,Lista de medicamentos potencialmente inapropiados ,Alert doctors ,Neurology ,Health Care::Health Care Facilities, Manpower, and Services::Health Services::Medical Errors::Medication Errors::Inappropriate Prescribing [Medical Subject Headings] ,Cardiovascular Diseases ,Female ,Research Article ,medicine.medical_specialty ,Insomnia ,Endocrine Disorders ,Geriatric Psychiatry ,Hospitalized-patients ,Population ,Cardiology ,Beers Criteria ,Stopp/start criteria ,Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus [Medical Subject Headings] ,Drug Prescriptions ,03 medical and health sciences ,Mental Health and Psychiatry ,Diabetes Mellitus ,Humans ,Adults ,Medical prescription ,Diseases::Cardiovascular Diseases [Medical Subject Headings] ,Cost outcomes ,Primary Care ,Aged ,Polypharmacy ,Primary Health Care ,Mood Disorders ,business.industry ,lcsh:R ,People ,Dyssomnias ,Prescriptions/screening tool ,Health Care ,Cross-Sectional Studies ,Age Groups ,Health Care::Health Care Facilities, Manpower, and Services::Health Services::Pharmaceutical Services::Prescriptions::Drug Prescriptions [Medical Subject Headings] ,Metabolic Disorders ,Family medicine ,People and Places ,Population Groupings ,lcsh:Q ,Prevalencia ,Sleep Disorders ,business - Abstract
Emerging and changing evidence made it necessary to update STOPP-START criteria, and version 2 was published recently. In this study the objectives were to determine the prevalence of potentially inappropriate medication prescribing (PIM) in primary care using STOPP versions 1 (v1) and 2 (v2), as well as 2012 AGS Beers criteria, and analyze the factors associated with inappropriate prescribing according to STOPP/START v2. A cross-sectional study was carried out including community-dwelling older adults over the age of 65. Socio-demographic, clinical, functional and comprehensive drug therapy data were collected. The primary endpoint was the percentage of patients receiving at least one PIM. This variable was measured using three tools: STOPP v1, 2012 AGS Beers criteria and STOPP v2. Similarly, the percentage of patients receiving at least one potential prescribing omission (PPO) was calculated using START versions 1 and 2. A total of 1,615 prescriptions were reviewed. The median number of medications per patient was 7.1 drugs (+/- 3.8). The prevalence of elderly people exposed to polypharmacy (>= 5 medications) was 72.9%, whereas 28.4% of the participants took >= 10 drugs regularly. PIM were present in 18.7%, 37.3% and 40.4% of participants, according to the STOPP v1, 2012 Beers criteria and STOPP v2, respectively. According to STOPP v2, the number of medications taken (OR: 1.14, 1.06-1.25), the presence of a psychological disorder (OR: 2.22, 1.13-4.37) and insomnia (OR: 3.35, 1.80-6.32) were risk factors for taking a PIM. The prevalence of PPOs was 34.7% and 21.8% according to version 1 and 2, respectively. In conclusion, STOPP-START criteria have been remarkably modified, which is evidenced by the different prevalence rates detected using version 2, as compared to version 1. In fact, the level of agreement between version 1 and the updated version is only moderate. Special attention should be paid on benzodiazepines, which keep being the most frequent PIM.
- Published
- 2016