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16 results on '"appropriateness of prescription"'

1. ANALYSIS OF HOSPITAL ANTIBIOTIC PRESCRIPTIONS AFTER THE IMPLEMENTATION OF STEWARDSHIP: A RETROSPECTIVE OBSERVATIONAL STUDY IN TWO HOSPITALS IN NORTH-EASTERN SICILY

Author

Salvatore Coppolino, Veronica Crucitti, Febronia Federico, Emanuele Leotta, and Nadia Caporlingua

Subjects
antimicrobial resistance, antimicrobial stewardship, antibiotics, appropriateness of prescription, Medicine, Nursing, RT1-120
Abstract

Introduction: Antimicrobial resistance is a global problem caused by the inappropriate use of antibiotics. To combat this phenomenon, multidisciplinary antimicrobial stewardship programmes have been initiated, the primary objectives of which include improving both the level of appropriateness of prescription and clinicians’ awareness of the correct use of antibiotics. Objective/Purpose: The objective of the work was to conduct an analysis of antibiotic consumption at hospital level to assess the appropriateness of antibiotic prescription in a number of Operational Units. Method: From 01/01/2021 to 31/12/2022, data were extracted from the Pharmacy Operational Unit’s management software on the dispensing of antibiotics (injectable and oral use), the Defined Daily Doses, and the number of dosage units dispensed to the General Medicine, Intensive Care, General Surgery and Neurorehabilitation Operational Units of two hospitals. Results: Total antibiotic consumption was 7,845 dosage units in 2021 and 10,182 in 2022. The comparison of the defined daily dose values (4,565,485 in 2021 and 5,079,671 in 2022) is indicative of the use of antibiotics with different dosages, with a percentage increase of 11.3%. A comparison was also made between the Defined Daily Doses/100 bed-days delivered in 2021 and the regional and national figures, yielding a significantly lower figure than these latter figures. Conclusions: The loss of antibiotic efficacy threatens to throw healthcare systems into crisis, leading to in an increase in morbidity and mortality from infections. The implementation of antimicrobial stewardship programmes remains, at present, the best tool to harness in order to curb the phenomenon of antimicrobial resistance. There is therefore a need for increasingly specialised professionals in the field of infectious diseases. Nurses and pharmacists play a crucial role in antimicrobial stewardship programmes, as they collaborate not only in the implementation of antimicrobial guidelines, but also in the review of individual patient regimens in order to optimise treatment and in the training of healthcare personnel on the appropriate use of antimicrobials.

Published
2023
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2. Impact of Three Safety Interventions Targeting Off-Label Use of Immediate-Release Fentanyl on Prescription Trends: Interrupted Time Series Analysis.

Author

García-Sempere, Aníbal, Hurtado, Isabel, Peiró, Salvador, Sánchez-Sáez, Francisco, Rodríguez-Bernal, Clara Liliana, Puig-Ferrer, Magda, Escolano, Manuel, and Sanfélix-Gimeno, Gabriel

Subjects
TIME series analysis, OFF-label use (Drugs), CANCER pain, FENTANYL, MEDICAL prescriptions, MEDICATION reconciliation
Abstract

Background: The Spanish health authorities are concerned by the off-label use of immediate-release formulations of fentanyl (IRF) in noncancer pain and cancer pain in patients with no chronic pain therapy. Aim: To evaluate the impact of different interventions to improve appropriateness of IRF prescription on off-label prescription. Patients and methods: We used interrupted time series (ITS) to estimate immediate and trend changes of IRF prescription for noncancer pain (NCP) and breakthrough cancer pain (BCP) in patients with and without chronic cancer pain therapy associated with two medication reviews (I1 and I2) and the issue of a safety warning letter (I3) with data from a Spanish region with 5 million inhabitants, from 2015 to 2018. Results: The use of IRF for NCP in the region Valencia was reduced from about 1,800 prescriptions per week to around 1,400. The first medication review was followed by an immediate level change of −192.66 prescriptions per week (p < 0.001) and a downward trend change of −6.75 prescriptions/week (p < 0.001), resulting in a post-intervention trend of −1.99 (p < 0.001). I2 was associated with a trend change of -23.07 (p < 0.001) prescriptions/week. After I3, the trend changed markedly to 27.23 additional prescriptions/week, for a final post-intervention trend of 2.17 (p < 0.001). Controlled-ITS provided comparable results. For potentially inappropriate BCP use, the second medication review was followed by a downward, immediate level change of −10.10 prescriptions/week (p = 0.011) and a trend change of 2.31 additional prescriptions/week (p < 0.001) and the issue of the safety warning (I3) was followed by a downward trend change of −2.09 prescriptions/week (p = 0.007). Conclusion: Despite IRF prescription for NCP decreased, the interventions showed modest and temporary effect on off-label prescription. Our results call for a review of the design and implementation of safety interventions addressing inappropriate opioid use. [ABSTRACT FROM AUTHOR]

Published
2022
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3. Impact of Three Safety Interventions Targeting Off-Label Use of Immediate-Release Fentanyl on Prescription Trends: Interrupted Time Series Analysis

Author

Aníbal García-Sempere, Isabel Hurtado, Salvador Peiró, Francisco Sánchez-Sáez, Clara Liliana Rodríguez-Bernal, Magda Puig-Ferrer, Manuel Escolano, and Gabriel Sanfélix-Gimeno

Subjects
fentanyl, appropriateness of prescription, interrupted time series, policy interventions, pharmacoepidemiology, Therapeutics. Pharmacology, RM1-950
Abstract

Background: The Spanish health authorities are concerned by the off-label use of immediate-release formulations of fentanyl (IRF) in noncancer pain and cancer pain in patients with no chronic pain therapy.Aim: To evaluate the impact of different interventions to improve appropriateness of IRF prescription on off-label prescription.Patients and methods: We used interrupted time series (ITS) to estimate immediate and trend changes of IRF prescription for noncancer pain (NCP) and breakthrough cancer pain (BCP) in patients with and without chronic cancer pain therapy associated with two medication reviews (I1 and I2) and the issue of a safety warning letter (I3) with data from a Spanish region with 5 million inhabitants, from 2015 to 2018.Results: The use of IRF for NCP in the region Valencia was reduced from about 1,800 prescriptions per week to around 1,400. The first medication review was followed by an immediate level change of −192.66 prescriptions per week (p < 0.001) and a downward trend change of −6.75 prescriptions/week (p < 0.001), resulting in a post-intervention trend of −1.99 (p < 0.001). I2 was associated with a trend change of -23.07 (p < 0.001) prescriptions/week. After I3, the trend changed markedly to 27.23 additional prescriptions/week, for a final post-intervention trend of 2.17 (p < 0.001). Controlled-ITS provided comparable results. For potentially inappropriate BCP use, the second medication review was followed by a downward, immediate level change of −10.10 prescriptions/week (p = 0.011) and a trend change of 2.31 additional prescriptions/week (p < 0.001) and the issue of the safety warning (I3) was followed by a downward trend change of −2.09 prescriptions/week (p = 0.007).Conclusion: Despite IRF prescription for NCP decreased, the interventions showed modest and temporary effect on off-label prescription. Our results call for a review of the design and implementation of safety interventions addressing inappropriate opioid use.

Published
2022
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4. Quality of clinical direct oral anticoagulant prescribing and identification of risk factors for inappropriate prescriptions.

Author

Zhang, Zhu Xian, Garde, Ewoudt M. W., Söhne, Maaike, Harmsze, Ankie M., and Broek, Marcel P. H.

Subjects
*APIXABAN, *ANTIDOTES, *ANTICOAGULANTS, *MEDICAL prescriptions, *GLOMERULAR filtration rate, *ATRIAL fibrillation, *DRUG prescribing, *DRUGS
Abstract

Aims: Even though the use of direct oral anticoagulants (DOACs) is safe based on clinical outcomes, drug safety also depends on appropriateness of drug prescription, which is challenging for DOACs since many patient factors need to be considered. The aim of this study was to assess the appropriateness of DOAC prescriptions and to identify risk factors of determinants for inappropriate DOAC prescriptions. Methods: A retrospective study in a nonuniversity teaching hospital was performed of hospitalized patients (≥18 years) who received an initial DOAC prescription between February and August 2018. Appropriateness of prescribing was evaluated on 8 criteria by using a modified version of the medication appropriateness index. Results: A total of 770 initial DOAC prescriptions of inpatients were evaluated: 267 patients (34.6%) had at least met 1 inappropriate criterion for a DOAC prescription. The most frequent inappropriate criterion was dosage (17.4%). Of the 4 DOACs, dabigatran (21.6%) and apixaban (21.2%) were mostly inappropriate dosed. In a multivariable analysis, reduced renal function (estimated glomerular filtration rate <50 mL/min; odds ratio [OR] = 2.35; P <.001), a diagnosis of atrial fibrillation (OR = 1.87; P =.004), and 'prescribed by surgeons' (OR = 1.9; P =.013) were independently associated with inappropriateness of prescribing. Conclusion: This study has highlighted a high degree of inappropriate prescribing of DOACs. These results underline the need for targeted interventions to improve DOAC prescribing. [ABSTRACT FROM AUTHOR]

Published
2020
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5. Appropriateness of prescription of oral anticoagulant therapy in acutely hospitalized older people with atrial fibrillation. Secondary analysis of the SIM‐AF cluster randomized clinical trial.

Author

Antoniazzi, Stefania, Ardoino, Ilaria, Proietti, Marco, Monzani, Valter, Mannucci, Pier Mannuccio, Nobili, Alessandro, and Franchi, Carlotta

Subjects
*CLUSTER randomized controlled trials, *ATRIAL fibrillation, *OLDER people, *ANTICOAGULANTS, *MYOCARDIAL depressants, *HOSPITAL admission & discharge, *SECONDARY analysis, *ALCOHOL
Abstract

Aims: To assess the appropriateness of oral anticoagulant (OAC) prescription and its associated factors in acutely hospitalized elderly patients. Methods: Data were obtained from the prospective phase of SIM‐AF (SIMulation‐based technologies to improve the appropriate use of oral anticoagulants in hospitalized elderly patients with Atrial Fibrillation) randomized controlled trial, aimed to test whether an educational intervention improved OAC prescription, compared to current clinical practice, in internal medicine wards. In this secondary analysis, appropriateness of OAC prescription was assessed at hospital admission and discharge. Results: For 246 patients, no significant differences were found between arms (odds ratio 1.38, 95% confidence interval [CI] 0.84–2.28) in terms of appropriateness of OAC prescription. Globally, 92 patients (37.4%, 95% CI = 31.6–43.6%) were inappropriately prescribed or not prescribed at hospital discharge. Among 51 patients inappropriately prescribed, 82% showed errors on dosage, being mainly under‐dosed (n = 29, 56.9%), and among 41 inappropriately not prescribed, 98% were taking an antiplatelet drug. Factors independently associated with a lower probability of appropriateness at discharge were those related to a higher risk of bleeding (older age, higher levels of aspartate aminotransferase, history of falls, alcohol consumption) and antiplatelet prescription at admission. The prescription of OACs at admission was the strongest predictor of appropriateness at discharge (odds ratio = 7.43, 95% CI = 4.04–13.73). Conclusions: A high proportion of hospitalized older patients with AF remains inappropriately prescribed or nonprescribed with OACs. The management of these patients at hospital admission is the strongest predictor of prescription appropriateness at discharge. [ABSTRACT FROM AUTHOR]

Published
2019
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6. Inappropriate prescription of benzodiazepines in acutely hospitalized older patients.

Author

Franchi, C., Rossio, R., Ardoino, I., Mannucci, P.M., and Nobili, A.

Subjects
*BENZODIAZEPINES, *HOSPITAL patients, *GERIATRIC care units, *OLDER patients, *HOSPITAL admission & discharge, *OLDER people, *MEDICAL prescriptions
Abstract

• At hospital discharge, 62% of older patients used benzodiazepines (BDZs) that were inappropriately prescribed. • The inappropriateness of BDZ prescription slightly decreased from admission to discharge. • For most patients inappropriately prescribed at admission, prescription was still inappropriate at discharge. • Among patients first prescribed BDZ at discharge, half were inappropriately prescribed. • These findings indicate that internists and geriatricians missed the opportunity to improve the quality of prescription of this class of drug in older people. Benzodiazepines (BDZs) are widely prescribed in older people. The aims of the study are to assess the prevalence of inappropriate prescription of BZDs and the associated factors in acutely hospitalized older patients. Patients aged 65 years or more hospitalized from 2010 to 2017 in more than 100 Italian internal medicine and geriatric wards in the frame of the REPOSI register were included if prescribed with BDZs at hospital admission or discharge. Appropriateness of prescription was assessed according to the 2015 Beers criteria and their modified French and German versions. Among 4681 patients discharged from hospital, 15% (N = 710) were discharged with BDZs, and 62% of them (N = 441, 95% CI: 58.5%–65.6%) were inappropriately prescribed, being prescribed with BDZ to be always avoided in the elderly (45%), at higher doses than recommended (31%) or with no appropriate clinical conditions (19%). From admission to discharge the prevalence of inappropriate BDZ prescription decreased by 4%, but 62% of patients inappropriately prescribed at admission were still inappropriately prescribed at discharge. Among the 179 patients first prescribed at the time of discharge, half were inappropriately prescribed. Being female (OR 1.32, 95%CI 0.95–1.85), enrolled in REPOSI during the years 2016 and 2017 (OR 1.94, 95%CI 1.10–3.39; OR 1.57, 95%CI 0.95–2.58) and living in nursing homes (OR 2.04, 95%CI 0.95–4.37) were associated with an increased risk to be inappropriately prescribed. This study shows a high prevalence of inappropriate use of BDZ in acutely hospitalized older patients both at hospital admission and discharge. [ABSTRACT FROM AUTHOR]

Published
2019
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7. Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation.

Author

Franchi, Carlotta, Antoniazzi, Stefania, Proietti, Marco, Nobili, Alessandro, Mannucci, Pier Mannuccio, and on behalf of the SIM‐AF Collaborators

Subjects
*DRUG prescription laws, *ATRIAL fibrillation, *ANTICOAGULANTS, *GERIATRIC assessment, *OLDER patients, *HEALTH
Abstract

Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high‐risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods: Data were obtained from the retrospective phase of Simulation‐based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM‐AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in those who were and were not prescribed OACs at hospital discharge. Multivariable logistic regression was used to establish factors independently associated with the appropriateness of OAC prescription. Results: A total of 328 patients were included in the retrospective phase of the study. Of these, almost 44% (N = 143) were inappropriately prescribed OACs, being mainly underprescribed or prescribed an inappropriate antithrombotic drug (N = 88). Among the patients prescribed OACs (N = 221), errors in the prescribed doses were the most frequent cause of inappropriate use (N = 55). Factors associated with a higher degree of patient frailty were inversely associated with the appropriateness of OAC prescription. Conclusions: In hospitalized older patients with AF, there is still a high prevalence of inappropriate OAC prescribing. Characteristics usually related to frailty are associated with the inappropriate prescribing. These findings point to the need for targeted interventions designed for internists and geriatricians, aimed at improving the appropriate prescribing of OACs in this complex and high‐risk population. [ABSTRACT FROM AUTHOR]

Published
2018
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8. Kidney Disease Management in the Hospital Setting: A Focus on Inappropriate Drug Prescriptions in Older Patients

Author

Vincenzo, Arcoraci, Maria Antonietta Barbieri, Michelangelo, Rottura, Alessandro, Nobili, Giuseppe, Natoli, Christiano, Argano, Giovanni, Squadrito, Francesco, Squadrito, Salvatore, Corrao, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Irene, Mattioli, Gianni, Biolo, Michela, Zanetti, Giacomo, Bartelloni, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Graziana, Lupattelli, Vanessa, Bianconi, Riccardo, Alcidi, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Vincenza, Beneduce, Federica, Cacioppo, Massimo, Raspanti, Marco, Zoli, Maria Laura Matacena, Giuseppe, Orio, Eleonora, Magnolfi, Giovanni, Serafini, Angelo, Simili, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Giovanna, Fabio, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Matteo, Cesari, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Simona, Leoni, Alessandra Danuta Di Mauro, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Giovanna, Leoncini, Luigi, Anastasio, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Antonella, Giorgi, Christian, Gracin, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Andrea, Volpini, Daniela, Lucente, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giuseppe, Bellelli, Maurizio, Corsi, Cesare, Antonucci, Chiara, Sidoli, Giulia, Principato, Franco, Arturi, Elena, Succurro, Bruno, Tassone, Federica, Giofrè, Maria Grazia Serra, Maria Antonietta Bleve, Antonio, Brucato, Teresa De Falco, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, DE GIORGI, Alfredo, Ruana, Tiseo, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudia, Catalano, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Silvia, Schiavone, Alessio, Bragagni, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Carlo, Custodero, Luigi, Fenoglio, Andrea, Falcetta, Fracanzani, Anna L., Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Pasquale, Agosti, Valter, Monzani, Valeria, Savojardo, Giuliana, Ceriani, Francesco, Salerno, Giada, Pallini, Fabrizio, Montecucco, Luciano, Ottonello, Lara, Caserza, Giulia, Vischi, Nicola Lucio Liberato, Tiziana, Tognin, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Maria Stella Pisciotta, Francesco Baffa Bellucci, Stefano, Buffelli, Giuseppe, Montrucchio, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Carl, Margaria, Maura, Sanino, Francesco, Violi, Ludovica, Perri, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Roberto Davide Diprizio, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Matteo, Galassi, Yasmine, Grassi, Alessio, Greco, Angela, Sciacqua, Maria, Perticone, Rosa, Battaglia, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Alfio, Gennaro, Agostino, Gaudio, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Carlo, Vigorito, Antonio, Cittadini, Guido, Moreo, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Roberta, Gonella, Domenico, Cerminara, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Leonardo, Sechi, Cristiana, Catena, Gianluca, Colussi, Alessandro, Cavarape, Andea Da Porto, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Margherita, Grossi, Stefano Del Giacco, Davide, Firinu, Giulia, Costanzo, Giacomo, Argiolas, Giuseppe, Montalto, Anna, Licata, Filippo Alessandro Montalto, Francesco, Corica, Giorgio, Basile, Antonino, Catalano, Federica, Bellone, Concetto, Principato, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Giandomenico Nigro Imperiale, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Mattia, Bellan, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Federico, Napoli, Italia, Aiello, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Silvia, Ghidoni, Teresa, Salvatore, Lucio, Monaco, Carmen, Ricozzi, Alberto, Pilotto, Ilaria, Indiano, Federica, Gandolfo., Arcoraci V., Barbieri M.A., Rottura M., Nobili A., Natoli G., Argano C., Squadrito G., Squadrito F., and Corrao S.

Subjects
medicine.medical_specialty, appropriateness of prescription, prescribing patterns, Renal function, Context (language use), RM1-950, Logistic regression, NO, chemistry.chemical_compound, older patient, Internal medicine, hospital setting, medicine, Pharmacology (medical), LS4_4, Medical prescription, prescribing pattern, appropriateness of prescriptions, chronic kidney disease, hospital setting, older patients, prescribing patterns, real-world data, Original Research, Pharmacology, Creatinine, real-world data, business.industry, Retrospective cohort study, medicine.disease, older patients, appropriateness of prescriptions, chronic kidney disease, chemistry, Observational study, Therapeutics. Pharmacology, business, Kidney disease
Abstract

Aging with multimorbidity and polytherapy are the most significant factors that could led to inappropriate prescribing of contraindicated medications in patients with chronic kidney disease (CKD). The aim of this study was to evaluate the prescriptions of contraindicated drugs in older adults in CKD and to identify their associated factors in a hospital context. An observational retrospective study was carried out considering all patients ≥65 years with at least one serum creatinine value recorded into the REPOSI register into 2010–2016 period. The estimated glomerular filtration rate (eGFR) was applied to identify CKD. A descriptive analysis was performed to compare demographic and clinical characteristics; logistic regression models were used to estimate factors of inappropriate and percentage changes of drug use during hospitalization. A total of 4,713 hospitalized patients were recorded, of which 49.8% had an eGFR 2; the 21.9% were in treatment with at least one inappropriate drug at the time of hospital admission with a decrease of 3.0% at discharge (p = 0.010). The probability of using at least one contraindicated drug was significantly higher in patients treated with more several drugs (OR 1.21, 95% CI 1.16–1.25, p p < 0.001; G5: 19.38, 11.51–32.64, p < 0.001). Low-dose acetylsalicylic acid was the contraindicated drug mainly used at the time of admission, reducing 1.2% at discharge. An overall increase in therapeutic appropriateness in hospitalized older patients with CKD was observed, despite a small percentage of therapeutic inappropriateness at discharge that underlines the need for a closer collaboration with the pharmacologist to improve the drug management.

Published
2021

9. Quality of clinical Direct Oral Anticoagulants (DOACs) prescribing and identification of risk factors for inappropriate prescriptions

Author

Zhang, Zhu Xian, van de Garde, Ewoudt Meine Walraven, Söhne, Maaike, Harmsze, Ankie Maxelante, van den Broek, Marcel Pieter Henricus, Afd Pharmacoepi & Clinical Pharmacology, and Pharmacoepidemiology and Clinical Pharmacology

Subjects
medication errors, appropriateness of prescription, DOAC, Taverne, prescribing patterns, Medication Appropriateness Index
Abstract

AIMS: Even though the use of Direct Oral Anticoagulants (DOACs) is safe based on clinical outcomes, drug safety also depends on appropriateness of drug prescription, which is challenging for DOACs since many patient factors need to be considered. The aim of this study was to assess the appropriateness of DOAC prescriptions and to identify risk factors of determinants for inappropriate DOAC prescriptions. METHOD: A retrospective study in a non-university teaching hospital was performed of hospitalized patients (≥18 years) who received an initial DOAC prescription between February and August 2018. Appropriateness of prescribing was evaluated on eight criteria by using a modified version of the Medication Appropriateness Index (MAI). RESULTS: A total of 770 initial DOAC prescriptions of inpatients were evaluated: 267 patients (34.6%) had at least met one inappropriate criterion for a DOAC prescription. The most frequent inappropriate criterion was 'dosage' (17.4%). Of all the four DOACs, dabigatran (21.6%) and apixaban (21.2%) were mostly inappropriate dosed. In a multivariable analysis, reduced renal function (eGFR < 50 mL/min) (OR=2.35; p

Published
2020

10. Inappropriate prescription of benzodiazepines in acutely hospitalized older patients

Author

Franchi, C, Rossio, R, Ardoino, I, Mannucci, P, Nobili, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Corrao, S, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arnò, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Cesari, M, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccalà, G, D'Aurizio, G, Romanelli, G, Marengoni, A, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabbà, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, A, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Ferrari, B, Colombo, G, Agosti, P, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Salerno, F, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Violi, F, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, F, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffrè, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Napoli, F, Mannucci, PM, Pulixi, EA, Bassi, SL, Pasini, FL, Capecchi, PL, Modeo, ME, Cappellini, MD, De Amicis, MM, Rossi, PD, Ottolini, BB, Lenti, MV, Dominioni, CC, Secchi, MB, Guagnano, MT, Gentilucci, UV, Serra, MG, Bleve, MA, Sajeva, MR, Rabuini, MV, Rizzo, MR, Vella, FS, De Vincenzo, GM, Fracanzani, AL, Liberato, NL, Bianchi, GB, Libbra, MV, FIlice, M, Martino, GP, Pipita, ME, Marra, AM, Nava, MC, Ceda, GP, Maggio, MG, Montalto, FA, Fra, GP, Franchi, C, Rossio, R, Ardoino, I, Mannucci, P, Nobili, A, Prisco, D, Silvestri, E, Emmi, G, Bettiol, A, Caterina, C, Biolo, G, Zanetti, M, Guadagni, M, Zaccari, M, Chiuch, M, Vanoli, M, Grignani, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Lupattelli, G, Mannarino, E, Bianconi, V, Paciullo, F, Alcidi, R, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Girelli, D, Busti, F, Marchi, G, Barbagallo, M, Dominguez, L, Cocita, F, Beneduce, V, Plances, L, Corrao, S, Natoli, G, Mularo, S, Raspanti, M, Cavallaro, F, Zoli, M, Lazzari, I, Brunori, M, Fabbri, E, Magalotti, D, Arnò, R, Pasini, F, Capecchi, P, Palasciano, G, Modeo, M, Di Gennaro, C, Cappellini, M, Maira, D, Di Stefano, V, Fabio, G, Seghezzi, S, Mancarella, M, De Amicis, M, De Luca, G, Scaramellini, N, Cesari, M, Rossi, P, Damanti, S, Clerici, M, Conti, F, Bonini, G, Ottolini, B, Di Sabatino, A, Miceli, E, Lenti, M, Pisati, M, Dominioni, C, Murialdo, G, Marra, A, Cattaneo, F, Pontremoli, R, Beccati, V, Nobili, G, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Cipollone, F, Guagnano, M, Valeriani, E, Rossi, I, Mancuso, G, Calipari, D, Bartone, M, Delitala, G, Berria, M, Pes, C, Delitala, A, Muscaritoli, M, Molfino, A, Petrillo, E, Zuccalà, G, D'Aurizio, G, Romanelli, G, Marengoni, A, Zucchelli, A, Manzoni, F, Volpini, A, Picardi, A, Gentilucci, U, Gallo, P, Dell'Unto, C, Annoni, G, Corsi, M, Bellelli, G, Zazzetta, S, Mazzola, P, Szabo, H, Bonfanti, A, Arturi, F, Succurro, E, Rubino, M, Tassone, B, Sesti, G, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Fabris, F, Bertozzi, I, Bogoni, G, Rabuini, M, Cosi, E, Scarinzi, P, Amabile, A, Omenetto, E, Prandini, T, Manfredini, R, Fabbian, F, Boari, B, De Giorgi, A, Tiseo, R, De Giorgio, R, Paolisso, G, Rizzo, M, Borghi, C, Strocchi, E, Ianniello, E, Soldati, M, Sabbà, C, Vella, F, Suppressa, P, Schilardi, A, Loparco, F, De Vincenzo, G, Comitangelo, A, Amoruso, E, Fenoglio, L, Falcetta, A, Bracco, C, Fracanzani, A, Fargion, S, Tiraboschi, S, Cespiati, A, Oberti, G, Sigon, G, Peyvandi, F, Ferrari, B, Colombo, G, Agosti, P, Monzani, V, Savojardo, V, Folli, C, Ceriani, G, Salerno, F, Pallini, G, Dallegri, F, Ottonello, L, Liberale, L, Caserza, L, Salam, K, Liberato, N, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Ferrandina, C, Montrucchio, G, Petitti, P, Peasso, P, Favale, E, Poletto, C, Salmi, R, Gaudenzi, P, Violi, F, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Campiotti, L, Grossi, A, Bertolotti, M, Mussi, C, Lancellotti, G, Libbra, M, Dondi, G, Pellegrini, E, Carulli, L, Galassi, M, Grassi, Y, Perticone, F, Perticone, M, Battaglia, R, Filice, M, Maio, R, Stanghellini, V, Ruggeri, E, del Vecchio, S, Salvi, A, Leonardi, R, Damiani, G, Capeci, W, Gabrielli, A, Mattioli, M, Martino, G, Biondi, L, Pettinari, P, Ghio, R, Dal Col, A, Minisola, S, Colangelo, L, Cilli, M, Labbadia, G, Afeltra, A, Marigliano, B, Pipita, M, Castellino, P, Zanoli, L, Pignataro, S, Gennaro, A, Blanco, J, Saracco, V, Fogliati, M, Bussolino, C, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Gasparini, F, Prolo, S, Pina, G, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Gruden, G, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffrè, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Passariello, N, Rinaldi, L, Berti, F, Famularo, G, Tarsitani, P, Castello, R, Pasino, M, Ceda, G, Maggio, M, Morganti, S, Artoni, A, Del Giacco, S, Firinu, D, Losa, F, Paoletti, G, Costanzo, G, Montalto, G, Licata, A, Malerba, V, Montalto, F, Lasco, A, Basile, G, Catalano, A, Malatino, L, Stancanelli, B, Terranova, V, Di Marca, S, Di Quattro, R, La Malfa, L, Caruso, R, Mecocci, P, Ruggiero, C, Boccardi, V, Meschi, T, Lauretani, F, Ticinesi, A, Nouvenne, A, Minuz, P, Fondrieschi, L, Pirisi, M, Fra, G, Sola, D, Porta, M, Riva, P, Quadri, R, Larovere, E, Novelli, M, Scanzi, G, Mengoli, C, Provini, S, Ricevuti, L, Simeone, E, Scurti, R, Tolloso, F, Tarquini, R, Valoriani, A, Dolenti, S, Vannini, G, Tedeschi, A, Trotta, L, Volpi, R, Bocchi, P, Vignali, A, Harari, S, Lonati, C, Cattaneo, M, Napoli, F, Mannucci, PM, Pulixi, EA, Bassi, SL, Pasini, FL, Capecchi, PL, Modeo, ME, Cappellini, MD, De Amicis, MM, Rossi, PD, Ottolini, BB, Lenti, MV, Dominioni, CC, Secchi, MB, Guagnano, MT, Gentilucci, UV, Serra, MG, Bleve, MA, Sajeva, MR, Rabuini, MV, Rizzo, MR, Vella, FS, De Vincenzo, GM, Fracanzani, AL, Liberato, NL, Bianchi, GB, Libbra, MV, FIlice, M, Martino, GP, Pipita, ME, Marra, AM, Nava, MC, Ceda, GP, Maggio, MG, Montalto, FA, and Fra, GP

Abstract

Benzodiazepines (BDZs) are widely prescribed in older people. The aims of the study are to assess the prevalence of inappropriate prescription of BZDs and the associated factors in acutely hospitalized older patients. Patients aged 65 years or more hospitalized from 2010 to 2017 in more than 100 Italian internal medicine and geriatric wards in the frame of the REPOSI register were included if prescribed with BDZs at hospital admission or discharge. Appropriateness of prescription was assessed according to the 2015 Beers criteria and their modified French and German versions. Among 4681 patients discharged from hospital, 15% (N = 710) were discharged with BDZs, and 62% of them (N = 441, 95% CI: 58.5%–65.6%) were inappropriately prescribed, being prescribed with BDZ to be always avoided in the elderly (45%), at higher doses than recommended (31%) or with no appropriate clinical conditions (19%). From admission to discharge the prevalence of inappropriate BDZ prescription decreased by 4%, but 62% of patients inappropriately prescribed at admission were still inappropriately prescribed at discharge. Among the 179 patients first prescribed at the time of discharge, half were inappropriately prescribed. Being female (OR 1.32, 95%CI 0.95–1.85), enrolled in REPOSI during the years 2016 and 2017 (OR 1.94, 95%CI 1.10–3.39; OR 1.57, 95%CI 0.95–2.58) and living in nursing homes (OR 2.04, 95%CI 0.95–4.37) were associated with an increased risk to be inappropriately prescribed. This study shows a high prevalence of inappropriate use of BDZ in acutely hospitalized older patients both at hospital admission and discharge.

Published
2019

11. Index.

Subjects
*PERIODICAL indexes, *PERIODICALS, *PHARMACOLOGY
Abstract

Presents an index related to pharmacology published in the June 15, 2003 issue of the journal 'Alimentary Pharmacology & Therapeutics.'

Published
2003
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12. Inappropriate prescription of benzodiazepines in acutely hospitalized older patients

Author

Carlotta, Franchi, Raffaella, Rossio, Ilaria, Ardoino, Pier Mannuccio Mannucci, Alessandro, Nobili, Domenico, Prisco, Elena, Silvestri, Giacomo, Emmi, Alessandra, Bettiol, Caterina, Cenci, Gianni, Biolo, Michela, Zanetti, Martina, Guadagni, Michele, Zaccari, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Graziana, Lupattelli, Elmo, Mannarino, Vanessa, Bianconi, Francesco, Paciullo, Riccardo, Alcidi, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Domenico, Girelli, Fabiana, Busti, Giacomo, Marchi, Mario, Barbagallo, Ligia, Dominguez, Floriana, Cocita, Vincenza, Beneduce, Lidia, Plances, Salvatore, Corrao, Giuseppe, Natoli, Salvatore, Mularo, Massimo, Raspanti, Federica, Cavallaro, Marco, Zoli, Ilaria, Lazzari, Mattia, Brunori, Elisa, Fabbri, Donatella, Magalotti, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Giuseppe, Palasciano, Maria Ester Modeo, Carla Di Gennaro, Maria Domenica Cappellini, Diletta, Maira, Valeria Di Stefano, Giovanna, Fabio, Sonia, Seghezzi, Marta, Mancarella, Margherita Migone De Amicis, Giacomo De Luca, Natalia, Scaramellini, Matteo, Cesari, Paolo Dionigi Rossi, Sarah, Damanti, Marta, Clerici, Federica, Conti, Giulia, Bonini, Barbara Brignolo Ottolini, Antonio Di Sabatino, Emanuela, Miceli, Marco Vincenzo Lenti, Martina, Pisati, Costanza Caccia Dominioni, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Roberto, Pontremoli, Valentina, Beccati, Giulia, Nobili, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Francesco, Cipollone, Maria Teresa Guagnano, Emanuele, Valeriani, Ilaria, Rossi, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Giuseppe, Delitala, Maria, Berria, Chiara, Pes, Alessandro, Delitala, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Gabriella, D’Aurizio, Giuseppe, Romanelli, Alessandra, Marengoni, Alberto, Zucchelli, Francesca, Manzoni, Andrea, Volpini, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Chiara, Dell’Unto, Giorgio, Annoni, Maurizio, Corsi, Giuseppe, Bellelli, Sara, Zazzetta, Paolo, Mazzola, Hajnalka, Szabo, Alessandra, Bonfanti, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Bruno, Tassone, Giorgio, Sesti, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Fabrizio, Fabris, Irene, Bertozzi, Giulia, Bogoni, Maria Victoria Rabuini, Elisabetta, Cosi, Paolo, Scarinzi, Annalisa, Amabile, Elisabetta, Omenetto, Tancredi, Prandini, Manfredini, Roberto, Fabbian, Fabio, Benedetta, Boari, Alfredo De Giorgi, Ruana, Tiseo, DE GIORGIO, Roberto, Giuseppe, Paolisso, Maria Rosaria Rizzo, Claudio, Borghi, Enrico, Strocchi, Eugenia, Ianniello, Mario, Soldati, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Pasquale, Agosti, Andrea, Schilardi, Francesca, Loparco, Giovanni Michele De Vincenzo, Alessio, Comitangelo, Emanuele, Amoruso, Luigi, Fenoglio, Andrea, Falcetta, Christian, Bracco, Fracanzani, Anna L., Silvia, Fargion, Silvia, Tiraboschi, Annalisa, Cespiati, Giovanna, Oberti, Giordano, Sigon, Flora, Peyvandi, Barbara, Ferrari, Giulia, Colombo, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Giuliana, Ceriani, Francesco, Salerno, Giada, Pallini, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Lara, Caserza, Kassem, Salam, Nicola Lucio Liberato, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Camillo, Ferrandina, Giuseppe, Montrucchio, Paolo, Petitti, Paolo, Peasso, Edoardo, Favale, Cesare, Poletto, Raffaella, Salmi, Piergiorgio, Gaudenzi, Francesco, Violi, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Leonardo, Campiotti, Alessandra, Grossi, Marco, Bertolotti, Chiara, Mussi, Giulia, Lancellotti, Maria Vittoria Libbra, Giulia, Dondi, Elisa, Pellegrini, Lucia, Carulli, Matteo, Galassi, Yasmine, Grassi, Francesco, Perticone, Maria, Perticone, Rosa, Battaglia, Marco, Filice, Raffaele, Maio, Vincenzo, Stanghellini, Eugenio, Ruggeri, Sara del Vecchio, Andrea, Salvi, Roberto, Leonardi, Giampaolo, Damiani, William, Capeci, Armando, Gabrielli, Massimo, Mattioli, Giuseppe Pio Martino, Lorenzo, Biondi, Pietro, Pettinari, Riccardo, Ghio, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Mirella, Cilli, Giancarlo, Labbadia, Antonella, Afeltra, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Luca, Zanoli, Samuele, Pignataro, Alfio, Gennaro, Julien, Blanco, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesca, Gasparini, Silvia, Prolo, Gloria, Pina, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Gabriella, Gruden, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Nicola, Passariello, Luca, Rinaldi, Franco, Berti, Giuseppe, Famularo, Patrizia, Tarsitani, Roberto, Castello, Michela, Pasino, Gian Paolo Ceda, Marcello Giuseppe Maggio, Simonetta, Morganti, Andrea, Artoni, Stefano Del Giacco, Davide, Firinu, Francesca, Losa, Giovanni, Paoletti, Giulia, Costanzo, Giuseppe, Montalto, Anna, Licata, Valentina, Malerba, Filippo Alessandro Montalto, Antonino, Lasco, Giorgio, Basile, Antonino, Catalano, Lorenzo, Malatino, Benedetta, Stancanelli, Valentina, Terranova, Salvatore Di Marca, Rosario Di Quattro, Lara La Malfa, Rossella, Caruso, Patrizia, Mecocci, Carmelinda, Ruggiero, Virginia, Boccardi, Tiziana, Meschi, Fulvio, Lauretani, Andrea, Ticinesi, Antonio, Nouvenne, Pietro, Minuz, Luigi, Fondrieschi, Mario, Pirisi, Gian Paolo Fra, Daniele, Sola, Massimo, Porta, Piero, Riva, Roberto, Quadri, Erica, Larovere, Marco, Novelli, Giorgio, Scanzi, Caterina, Mengoli, Stella, Provini, Laura, Ricevuti, Emilio, Simeone, Rosa, Scurti, Fabio, Tolloso, Roberto, Tarquini, Alice, Valoriani, Silvia, Dolenti, Giulia, Vannini, Alberto, Tedeschi, Lucia, Trotta, Riccardo, Volpi, Pietro, Bocchi, Alessandro, Vignali, Sergio, Harari, Chiara, Lonati, Mara, Cattaneo, Federico, Napoli., Franchi, C., Rossio R., Ardoino I., Mannucci P. M., Nobili A., and Rinaldi, Luca

Subjects
Male, medicine.medical_specialty, Beers Criteria, Socio-culturale, Inappropriate Prescribing, Hypnotic, 03 medical and health sciences, Benzodiazepines, 0302 clinical medicine, Older patients, Older peopl, Internal medicine and geriatric wards, Appropriateness of prescription, Benzodiazepine, Hypnotics, Older people, REPOSI register, 80 and over, Medicine, Humans, Pharmacology (medical), Medical prescription, Biological Psychiatry, Aged, Pharmacology, Aged, 80 and over, business.industry, Settore MED/09 - MEDICINA INTERNA, Patient Discharge, 030227 psychiatry, Hospitalization, Psychiatry and Mental health, Internal medicine and geriatric ward, Increased risk, Neurology, Hospital admission, Emergency medicine, Female, Neurology (clinical), business, Nursing homes, Appropriateness of prescription, Benzodiazepine, Hypnotics, Internal medicine and geriatric wards, Older peopl, 030217 neurology & neurosurgery, Human
Abstract

Benzodiazepines (BDZs) are widely prescribed in older people. The aims of the study are to assess the prevalence of inappropriate prescription of BZDs and the associated factors in acutely hospitalized older patients. Patients aged 65 years or more hospitalized from 2010 to 2017 in more than 100 Italian internal medicine and geriatric wards in the frame of the REPOSI register were included if prescribed with BDZs at hospital admission or discharge. Appropriateness of prescription was assessed according to the 2015 Beers criteria and their modified French and German versions. Among 4681 patients discharged from hospital, 15% (N = 710) were discharged with BDZs, and 62% of them (N = 441, 95% CI: 58.5%–65.6%) were inappropriately prescribed, being prescribed with BDZ to be always avoided in the elderly (45%), at higher doses than recommended (31%) or with no appropriate clinical conditions (19%). From admission to discharge the prevalence of inappropriate BDZ prescription decreased by 4%, but 62% of patients inappropriately prescribed at admission were still inappropriately prescribed at discharge. Among the 179 patients first prescribed at the time of discharge, half were inappropriately prescribed. Being female (OR 1.32, 95%CI 0.95–1.85), enrolled in REPOSI during the years 2016 and 2017 (OR 1.94, 95%CI 1.10–3.39; OR 1.57, 95%CI 0.95–2.58) and living in nursing homes (OR 2.04, 95%CI 0.95–4.37) were associated with an increased risk to be inappropriately prescribed. This study shows a high prevalence of inappropriate use of BDZ in acutely hospitalized older patients both at hospital admission and discharge.

Published
2019

13. Appropriateness of prescription of oral anticoagulant therapy in acutely hospitalized older people with atrial fibrillation. Secondary analysis of the SIM-AF cluster randomized clinical trial

Author

Stefania, Antoniazzi, Ilaria, Ardoino, Marco, Proietti, Valter, Monzani, Pier Mannuccio Mannucci, Alessandro, Nobili, Carlotta, Franchi, Paola, Santalucia, Maura, Marcucci, Silvano, Bosari, Barbara, Brignolo, Enrico, Nicolis, Fenoglio, Luigi M., Remo, Melchio, Fabrizio, Fabris, Maria Teresa Sartori, Roberto, Manfredini, Alfredo De Giorgi, Fabio, Fabbian, Gianni, Biolo, Michela, Zanetti, Nicola, Altamura, Carlo, Sabbà, Patrizia, Suppressa, Francesco, Bandiera, Carlo, Usai, Murialdo, Giovanni, Fezza, Francesca, Marra, Alessio, Castelli, Francesca, Cattaneo, Federico, Beccati, Valentina, Giovanni di Minno, Antonella, Tufano, Paola, Contaldi, Graziana, Lupattelli, Vanessa, Bianconi, Domenica, Cappellini, Cinzia, Hu, Francesca, Minonzio, Silvia, Fargion, Larry, Burdick, Paolo, Francione, Flora, Peyvandi, Raffaella, Rossio, Giulia, Colombo, Giuliana, Ceriani, Tiziano, Lucchi, Dario, Manfellotto, Irene, Caridi, Gino Roberto Corazza, Emanuela, Miceli, Donatella, Padula, Giacomo, Fraternale, Luigina, Guasti, Alessandro, Squizzato, Andrea, Maresca, Nicola Lucio Liberato, Tiziana, Tognin, Renzo, Rozzini, Francesco Baffa Bellucci, Maurizio, Muscaritoli, Alessio, Molfino, Enrico, Petrillo, Maurizio, Dore, Paolo, Raviolo, Francesca, Mete, Miriam, Gino, Francesco, Franceschi, Maurizio, Gabrielli, Francesco, Perticone, Maria, Perticone, Marco, Bertolotti, Chiara, Mussi, Claudio, Borghi, Enrico, Strocchi, Marilena, Durazzo, Paolo, Fornengo, Claudia, Ruatta, Dallegri, Franco, Ottonello, LUCIANO CARLO, Salam, Kassem, Caserza, Lara, Mario, Barbagallo, Giovanna Di Bella, Giorgio, Annoni, Adriana Antonella Bruni, Odetti, Patrizio, Nencioni, Alessio, Monacelli, Fiammetta, Armando, Napolitano, Antonio, Brucato, Anna, Valenti, Pietro, Castellino, Luca, Zanoli, and Marco, Mazzeo

Subjects
Male, Antiplatelet drug, appropriateness of prescription, Health Services for the Aged, medicine.medical_treatment, Administration, Oral, Inappropriate Prescribing, 030226 pharmacology & pharmacy, law.invention, 0302 clinical medicine, Patient Admission, Randomized controlled trial, law, Risk Factors, Atrial Fibrillation, Prevalence, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, Practice Patterns, Physicians', LS4_7, Aged, 80 and over, Clinical pharmacology, prescribing, Atrial fibrillation, Patient Discharge, Stroke, Female, drug utilization, medicine.medical_specialty, Socio-culturale, Hemorrhage, Drug Prescriptions, 03 medical and health sciences, Internal medicine, medicine, Humans, Medical prescription, Aged, Pharmacology, clinical trials, business.industry, Anticoagulants, Odds ratio, Original Articles, medicine.disease, Confidence interval, appropriateness of prescription, clinical pharmacology, clinical trials, drug utilization, medication errors, prescribing, Clinical trial, medication errors, clinical pharmacology, business
Abstract

Aims To assess the appropriateness of oral anticoagulant (OAC) prescription and its associated factors in acutely hospitalized elderly patients. Methods Data were obtained from the prospective phase of SIM-AF (SIMulation-based technologies to improve the appropriate use of oral anticoagulants in hospitalized elderly patients with Atrial Fibrillation) randomized controlled trial, aimed to test whether an educational intervention improved OAC prescription, compared to current clinical practice, in internal medicine wards. In this secondary analysis, appropriateness of OAC prescription was assessed at hospital admission and discharge. Results For 246 patients, no significant differences were found between arms (odds ratio 1.38, 95% confidence interval [CI] 0.84-2.28) in terms of appropriateness of OAC prescription. Globally, 92 patients (37.4%, 95% CI = 31.6-43.6%) were inappropriately prescribed or not prescribed at hospital discharge. Among 51 patients inappropriately prescribed, 82% showed errors on dosage, being mainly under-dosed (n = 29, 56.9%), and among 41 inappropriately not prescribed, 98% were taking an antiplatelet drug. Factors independently associated with a lower probability of appropriateness at discharge were those related to a higher risk of bleeding (older age, higher levels of aspartate aminotransferase, history of falls, alcohol consumption) and antiplatelet prescription at admission. The prescription of OACs at admission was the strongest predictor of appropriateness at discharge (odds ratio = 7.43, 95% CI = 4.04-13.73). Conclusions A high proportion of hospitalized older patients with AF remains inappropriately prescribed or nonprescribed with OACs. The management of these patients at hospital admission is the strongest predictor of prescription appropriateness at discharge.

Published
2018

14. Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

Author

Franchi, C, Antoniazzi, S, Proietti, M, Nobili, A, Mannucci, P, Santalucia, P, Monzani, V, Marcucci, M, Bosari, S, Brignolo, B, Nicolis, E, Ardoino, I, Fenoglio, L, Melchio, R, Fabris, F, Sartori, M, Manfredini, R, De Giorgi, A, Fabbian, F, Biolo, G, Zanetti, M, Altamura, N, Sabbà, C, Suppressa, P, Bandiera, F, Usai, C, Murialdo, G, Fezza, F, Marra, A, Castelli, F, Cattaneo, F, Beccati, V, di Minno, G, Tufano, A, Contaldi, P, Lupattelli, G, Bianconi, V, Cappellini, D, Hu, C, Minonzio, F, Fargion, S, Burdick, L, Francione, P, Peyvandi, F, Rossio, R, Colombo, G, Ceriani, G, Lucchi, T, Manfellotto, D, Caridi, I, Corazza, G, Miceli, E, Padula, D, Fraternale, G, Guasti, L, Squizzato, A, Maresca, A, Liberato, N, Tognin, T, Rozzini, R, Bellucci, F, Muscaritoli, M, Molfino, A, Petrillo, E, Dore, M, Mete, F, Gino, M, Franceschi, F, Gabrielli, M, Perticone, F, Perticone, M, Bertolotti, M, Mussi, C, Borghi, C, Strocchi, E, Durazzo, M, Fornengo, P, Dallegri, F, Ottonello, L, Salam, K, Caserza, L, Barbagallo, M, Di Bella, G, Annoni, G, Bruni, A, Odetti, P, Nencioni, A, Monacelli, F, Napolitano, A, Brucato, A, Valenti, A, Castellino, P, Zanoli, L, Mazzeo, M, Franchi, Carlotta, Antoniazzi, Stefania, Proietti, Marco, Nobili, Alessandro, Mannucci, Pier Mannuccio, Mannucci, PM, Brignolo,B, Ardoino,I, Fenoglio, LM, Sartori, MT, Hu,C, Corazza, GR, Liberato, NL, Bellucci, FB, Ottonello, LC, Bruni, AA, Franchi, C, Antoniazzi, S, Proietti, M, Nobili, A, Mannucci, P, Santalucia, P, Monzani, V, Marcucci, M, Bosari, S, Brignolo, B, Nicolis, E, Ardoino, I, Fenoglio, L, Melchio, R, Fabris, F, Sartori, M, Manfredini, R, De Giorgi, A, Fabbian, F, Biolo, G, Zanetti, M, Altamura, N, Sabbà, C, Suppressa, P, Bandiera, F, Usai, C, Murialdo, G, Fezza, F, Marra, A, Castelli, F, Cattaneo, F, Beccati, V, di Minno, G, Tufano, A, Contaldi, P, Lupattelli, G, Bianconi, V, Cappellini, D, Hu, C, Minonzio, F, Fargion, S, Burdick, L, Francione, P, Peyvandi, F, Rossio, R, Colombo, G, Ceriani, G, Lucchi, T, Manfellotto, D, Caridi, I, Corazza, G, Miceli, E, Padula, D, Fraternale, G, Guasti, L, Squizzato, A, Maresca, A, Liberato, N, Tognin, T, Rozzini, R, Bellucci, F, Muscaritoli, M, Molfino, A, Petrillo, E, Dore, M, Mete, F, Gino, M, Franceschi, F, Gabrielli, M, Perticone, F, Perticone, M, Bertolotti, M, Mussi, C, Borghi, C, Strocchi, E, Durazzo, M, Fornengo, P, Dallegri, F, Ottonello, L, Salam, K, Caserza, L, Barbagallo, M, Di Bella, G, Annoni, G, Bruni, A, Odetti, P, Nencioni, A, Monacelli, F, Napolitano, A, Brucato, A, Valenti, A, Castellino, P, Zanoli, L, Mazzeo, M, Franchi, Carlotta, Antoniazzi, Stefania, Proietti, Marco, Nobili, Alessandro, Mannucci, Pier Mannuccio, Mannucci, PM, Brignolo,B, Ardoino,I, Fenoglio, LM, Sartori, MT, Hu,C, Corazza, GR, Liberato, NL, Bellucci, FB, Ottonello, LC, and Bruni, AA

Abstract

Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods: Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in those who were and were not prescribed OACs at hospital discharge. Multivariable logistic regression was used to establish factors independently associated with the appropriateness of OAC prescription. Results: A total of 328 patients were included in the retrospective phase of the study. Of these, almost 44% (N = 143) were inappropriately prescribed OACs, being mainly underprescribed or prescribed an inappropriate antithrombotic drug (N = 88). Among the patients prescribed OACs (N = 221), errors in the prescribed doses were the most frequent cause of inappropriate use (N = 55). Factors associated with a higher degree of patient frailty were inversely associated with the appropriateness of OAC prescription. Conclusions: In hospitalized older patients with AF, there is still a high prevalence of inappropriate OAC prescribing. Characteristics usually related to frailty are associated with the inappropriate prescribing. These findings point to the need for targeted interventions designed for internists and geriatricians, aimed at improving the appropriate prescribing of OACs in this complex and high-risk population.

Published
2018

15. Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

Author

Franchi, C., Antoniazzi, S., Proietti, M., Nobili, A., Mannucci, P. M., Santalucia, P., Monzani, V., Marcucci, M., Bosari, S., Brignolo, B., Nicolis, E., Ardoino, I., Fenoglio, L. M., Melchio, R., Fabris, F., Sartori, M. T., Manfredini, R., De Giorgi, A., Fabbian, F., Biolo, G., Zanetti, M., Altamura, N., Sabba, C., Suppressa, P., Bandiera, F., Usai, C., Murialdo, G., Fezza, F., Marra, A., Castelli, F., Cattaneo, F., Beccati, V., di Minno, G., Tufano, A., Contaldi, P., Lupattelli, G., Bianconi, V., Cappellini, D., Hu, C., Minonzio, F., Fargion, S., Burdick, L., Francione, P., Peyvandi, F., Rossio, R., Colombo, G., Ceriani, G., Lucchi, T., Manfellotto, D., Caridi, I., Corazza, G. R., Miceli, E., Padula, D., Fraternale, G., Guasti, L., Squizzato, A., Maresca, A., Liberato, N. L., Tognin, T., Rozzini, R., Bellucci, F. B., Muscaritoli, M., Molfino, A., Petrillo, E., Dore, M., Mete, F., Gino, M., Franceschi, Francesco, Gabrielli, Maurizio, Perticone, F., Perticone, M., Bertolotti, M., Mussi, C., Borghi, C., Strocchi, E., Durazzo, M., Fornengo, P., Dallegri, F., Ottonello, L. C., Salam, K., Caserza, L., Barbagallo, M., Di Bella, G., Annoni, G., Bruni, A. A., Odetti, P., Nencioni, A., Monacelli, F., Napolitano, A., Brucato, A., Valenti, A., Castellino, P., Zanoli, L., Mazzeo, M., Franceschi F. (ORCID:0000-0001-6266-445X), Gabrielli M., Franchi, C., Antoniazzi, S., Proietti, M., Nobili, A., Mannucci, P. M., Santalucia, P., Monzani, V., Marcucci, M., Bosari, S., Brignolo, B., Nicolis, E., Ardoino, I., Fenoglio, L. M., Melchio, R., Fabris, F., Sartori, M. T., Manfredini, R., De Giorgi, A., Fabbian, F., Biolo, G., Zanetti, M., Altamura, N., Sabba, C., Suppressa, P., Bandiera, F., Usai, C., Murialdo, G., Fezza, F., Marra, A., Castelli, F., Cattaneo, F., Beccati, V., di Minno, G., Tufano, A., Contaldi, P., Lupattelli, G., Bianconi, V., Cappellini, D., Hu, C., Minonzio, F., Fargion, S., Burdick, L., Francione, P., Peyvandi, F., Rossio, R., Colombo, G., Ceriani, G., Lucchi, T., Manfellotto, D., Caridi, I., Corazza, G. R., Miceli, E., Padula, D., Fraternale, G., Guasti, L., Squizzato, A., Maresca, A., Liberato, N. L., Tognin, T., Rozzini, R., Bellucci, F. B., Muscaritoli, M., Molfino, A., Petrillo, E., Dore, M., Mete, F., Gino, M., Franceschi, Francesco, Gabrielli, Maurizio, Perticone, F., Perticone, M., Bertolotti, M., Mussi, C., Borghi, C., Strocchi, E., Durazzo, M., Fornengo, P., Dallegri, F., Ottonello, L. C., Salam, K., Caserza, L., Barbagallo, M., Di Bella, G., Annoni, G., Bruni, A. A., Odetti, P., Nencioni, A., Monacelli, F., Napolitano, A., Brucato, A., Valenti, A., Castellino, P., Zanoli, L., Mazzeo, M., Franceschi F. (ORCID:0000-0001-6266-445X), and Gabrielli M.

Abstract

Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods: Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in those who were and were not prescribed OACs at hospital discharge. Multivariable logistic regression was used to establish factors independently associated with the appropriateness of OAC prescription. Results: A total of 328 patients were included in the retrospective phase of the study. Of these, almost 44% (N = 143) were inappropriately prescribed OACs, being mainly underprescribed or prescribed an inappropriate antithrombotic drug (N = 88). Among the patients prescribed OACs (N = 221), errors in the prescribed doses were the most frequent cause of inappropriate use (N = 55). Factors associated with a higher degree of patient frailty were inversely associated with the appropriateness of OAC prescription. Conclusions: In hospitalized older patients with AF, there is still a high prevalence of inappropriate OAC prescribing. Characteristics usually related to frailty are associated with the inappropriate prescribing. These findings point to the need for targeted interventions designed for internists and geriatricians, aimed at improving the appropriate prescribing of OACs in this complex and high-risk population.

Published
2018

16. Appropriateness of oral anticoagulant therapy prescription and its associated factors in hospitalized older people with atrial fibrillation

Author

DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Facolta' di MEDICINA e CHIRURGIA, Da definire, and AREA MIN. 06 - Scienze mediche

Subjects
Pharmacology, appropriateness of prescription, oral anticoagulant, atrial fibrillation, internal medicine and geriatric wards, Pharmacology (medical), older patients
Abstract

none 98 no The SIM‐AF study was funded by a competitive grant from Bristol Myers Squibb/Pfizer Alliance, within the European Thrombosis Investigator‐Initiated Research Program (ERISTA) (Grant N° BMS ISR #CV 185‐483) Aims: Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65years or older. Methods: Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in those who were and were not prescribed OACs at hospital discharge. Multivariable logistic regression was used to establish factors independently associated with the appropriateness of OAC prescription. Results: A total of 328 patients were included in the retrospective phase of the study. Of these, almost 44% (N = 143) were inappropriately prescribed OACs, being mainly underprescribed or prescribed an inappropriate antithrombotic drug (N = 88). Among the patients prescribed OACs (N=221), errors in the prescribed doses were the most frequent cause of inappropriate use (N=55). Factors associated with a higher degree of patient frailty were inversely associated with the appropriateness of OAC prescription. Conclusions: In hospitalized older patients with AF, there is still a high prevalence of inappropriate OAC prescribing. Characteristics usually related to frailty are associated with the inappropriate prescribing. These findings point to the need for targeted interventions designed for internists and geriatricians, aimed at improving the appropriate prescribing of OACs in this complex and high-risk population. none Franchi, Carlotta*; Antoniazzi, Stefania; Proietti, Marco; Nobili, Alessandro; Mannucci, Pier Mannuccio; Santalucia, Paola; Monzani, Valter; Marcucci, Maura; Antoniazzi, Stefania; Bosari, Silvano; Mannucci, Pier Mannuccio; Franchi, Carlotta; Brignolo, Barbara; Proietti, Marco; Nicolis, Enrico; Ardoino, Ilaria; Fenoglio, Luigi M.; Melchio, Remo; Fabris, Fabrizio; Sartori, Maria Teresa; Manfredini, Roberto; De Giorgi, Alfredo; Fabbian, Fabio; Biolo, Gianni; Zanetti, Michela; Altamura, Nicola; Sabbà, Carlo; Suppressa, Patrizia; Bandiera, Francesco; Usai, Carlo; Murialdo, Giovanni; Fezza, Francesca; Marra, Alessio; Castelli, Francesca; Cattaneo, Federico; Beccati, Valentina; di Minno, Giovanni; Tufano, Antonella; Contaldi, Paola; Lupattelli, Graziana; Bianconi, Vanessa; Cappellini, Domenica; Hu, Cinzia; Minonzio, Francesca; Fargion, Silvia; Burdick, Larry; Francione, Paolo; Peyvandi, Flora; Rossio, Raffaella; Colombo, Giulia; Ceriani, Giuliana; Lucchi, Tiziano; Manfellotto, Dario; Caridi, Irene; Corazza, Gino Roberto; Miceli, Emanuela; Padula, Donatella; Fraternale, Giacomo; Guasti, Luigina; Squizzato, Alessandro; Maresca, Andrea; Liberato, Nicola Lucio; Tognin, Tiziana; Rozzini, Renzo; Bellucci, Francesco Baffa; Muscaritoli, Maurizio; Molfino, Alessio; Petrillo, Enrico; Dore, Maurizio; Mete, Francesca; Gino, Miriam; Franceschi, Francesco; Gabrielli, Maurizio; Perticone, Francesco; Perticone, Maria; Bertolotti, Marco; Mussi, Chiara; Borghi, Claudio; Strocchi, Enrico; Durazzo, Marilena; Fornengo, Paolo; Dallegri, Franco; Ottonello, Luciano Carlo; Salam, Kassem; Caserza, Lara; Barbagallo, Mario; Di Bella, Giovanna; Annoni, Giorgio; Bruni, Adriana Antonella; Odetti, Patrizio; Nencioni, Alessio; Monacelli, Fiammetta; Napolitano, Armando; Brucato, Antonio; Valenti, Anna; Castellino, Pietro; Zanoli, Luca; Mazzeo, Marco Franchi, Carlotta*; Antoniazzi, Stefania; Proietti, Marco; Nobili, Alessandro; Mannucci, Pier Mannuccio; Santalucia, Paola; Monzani, Valter; Marcucci, Maura; Antoniazzi, Stefania; Bosari, Silvano; Mannucci, Pier Mannuccio; Franchi, Carlotta; Brignolo, Barbara; Proietti, Marco; Nicolis, Enrico; Ardoino, Ilaria; Fenoglio, Luigi M.; Melchio, Remo; Fabris, Fabrizio; Sartori, Maria Teresa; Manfredini, Roberto; De Giorgi, Alfredo; Fabbian, Fabio; Biolo, Gianni; Zanetti, Michela; Altamura, Nicola; Sabbà, Carlo; Suppressa, Patrizia; Bandiera, Francesco; Usai, Carlo; Murialdo, Giovanni; Fezza, Francesca; Marra, Alessio; Castelli, Francesca; Cattaneo, Federico; Beccati, Valentina; di Minno, Giovanni; Tufano, Antonella; Contaldi, Paola; Lupattelli, Graziana; Bianconi, Vanessa; Cappellini, Domenica; Hu, Cinzia; Minonzio, Francesca; Fargion, Silvia; Burdick, Larry; Francione, Paolo; Peyvandi, Flora; Rossio, Raffaella; Colombo, Giulia; Ceriani, Giuliana; Lucchi, Tiziano; Manfellotto, Dario; Caridi, Irene; Corazza, Gino Roberto; Miceli, Emanuela; Padula, Donatella; Fraternale, Giacomo; Guasti, Luigina; Squizzato, Alessandro; Maresca, Andrea; Liberato, Nicola Lucio; Tognin, Tiziana; Rozzini, Renzo; Bellucci, Francesco Baffa; Muscaritoli, Maurizio; Molfino, Alessio; Petrillo, Enrico; Dore, Maurizio; Mete, Francesca; Gino, Miriam; Franceschi, Francesco; Gabrielli, Maurizio; Perticone, Francesco; Perticone, Maria; Bertolotti, Marco; Mussi, Chiara; Borghi, Claudio; Strocchi, Enrico; Durazzo, Marilena; Fornengo, Paolo; Dallegri, Franco; Ottonello, Luciano Carlo; Salam, Kassem; Caserza, Lara; Barbagallo, Mario; Di Bella, Giovanna; Annoni, Giorgio; Bruni, Adriana Antonella; Odetti, Patrizio; Nencioni, Alessio; Monacelli, Fiammetta; Napolitano, Armando; Brucato, Antonio; Valenti, Anna; Castellino, Pietro; Zanoli, Luca; Mazzeo, Marco

Published
2018

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