Prévalence et facteurs associés à la prescription sous-optimale des anti-thrombotiques selon les critères STOPP/START chez le sujet âgé en médecine générale. Étude observationnelle multicentrique en pharmacie d’officine

Objective: to assess the prevalence of inappropriate prescribing of antithrombotic therapy (AT) in older outpatients and to examine the associated factors. DESIGN: multicenter prospective study. Setting: 75 pharmacies in 11 French départements. Participants: 1178 patients aged =75 years coming to community pharmacy with prescription from general practitioners (GP) (48.8% female, mean age 82.8; 94% in Paris and surroundings). Data collection: 75 pharmacy trainee students collected data from patients structured interview and GP’s prescription into an electronic case report. Measurements: Updated 2014 STOPP/START criteria regarding AT were applied to each prescription. Factors associated with =1 STOPP-AT criteria and with =1 START-AT criteria were studied (uni and multivariate analyses). Results: –20% prescriptions had =1 STOPP-AT criteria and 12% =1 START-AT criteria. The most frequent STOPP and START-AT criteria were respectively AT prescribing despite a concurrent significant bleeding risk and omission of AT in chronic atrial fibrillation. Two factors were associated with =1 STOPP-AT criteria: the number of medications ([5-7[ OR 5.63 IC[1.66-19.08]; =10 OR 24.33 IC[7.55-78.38] p=10 OR 24,33 IC[7,55-78,38] p