Potentially inappropriate prescribing in older primary care patients.

<h4>Objectives</h4>The aim of the study was to determine the rate of Potentially Inappropriate Medicines (PIM) and Potential Prescription Omissions (PPO) according to Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Righ...

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Autores principales:	Sandra Vezmar Kovačević, Mika Simišić, Svetlana Stojkov Rudinski, Milica Ćulafić, Katarina Vučićević, Milica Prostran, Branislava Miljković
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3af9fd753b6146f19084184d4a20e83e
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spelling	oai:doaj.org-article:3af9fd753b6146f19084184d4a20e83e2021-11-18T08:21:34ZPotentially inappropriate prescribing in older primary care patients.1932-620310.1371/journal.pone.0095536https://doaj.org/article/3af9fd753b6146f19084184d4a20e83e2014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24763332/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>The aim of the study was to determine the rate of Potentially Inappropriate Medicines (PIM) and Potential Prescription Omissions (PPO) according to Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment (STOPP/START) criteria.<h4>Study design</h4>A cross-sectional survey in community pharmacy.<h4>Method</h4>A prospective cross-sectional study was performed, during March-May 2012, in five community pharmacies. Patients aged ≥65 years, who collected one or more prescribed medications, were asked to participate in the study, and an interview was scheduled. Patients were asked to provide their complete medical and biochemical record from their general practitioner.<h4>Results</h4>509 patients, mean age 74.8±6.5 years, 57.4% female, participated in the study. 164 PIM were identified in 139 patients (27.3%). The most common were: long-term use of long-acting benzodiazepines (20.7%), use of non-steroidal antiinflammatory drugs (NSAID) in patients with moderate-severe hypertension (20.1%), use of theophylline as monotherapy for chronic obstructive pulmonary disease (COPD, 15.9%) and use of aspirin without appropriate indication (15.2%). Patients with more than four prescpritions had a higher risk for PIM (OR 2.85, 95% CI 1.97-4.14, p<0.001). There were 439 PPO, identified in 257, (50.5%) patients. Predictors for PPO were older age, presence of diabetes, myocardial infarction, osteoporosis, stroke, COPD and/or angina pectoris.<h4>Conclusion</h4>STOPP/START criteria may be useful in identifying inappropriate prescribing and improving the current prescribing practices. Pharmacists should focus more on patients with more than four medications and/or patients with gout or pain accompanied with arterial hypertension because those patient may be at higher risk of PIM. Additionlly, patients older than 74 years with diabetes, osteoporosis, myocardial infarction, stroke, angina pectoris and/or COPD may have an increased risk of PPO.Sandra Vezmar KovačevićMika SimišićSvetlana Stojkov RudinskiMilica ĆulafićKatarina VučićevićMilica ProstranBranislava MiljkovićPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e95536 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sandra Vezmar Kovačević Mika Simišić Svetlana Stojkov Rudinski Milica Ćulafić Katarina Vučićević Milica Prostran Branislava Miljković Potentially inappropriate prescribing in older primary care patients.
description	<h4>Objectives</h4>The aim of the study was to determine the rate of Potentially Inappropriate Medicines (PIM) and Potential Prescription Omissions (PPO) according to Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment (STOPP/START) criteria.<h4>Study design</h4>A cross-sectional survey in community pharmacy.<h4>Method</h4>A prospective cross-sectional study was performed, during March-May 2012, in five community pharmacies. Patients aged ≥65 years, who collected one or more prescribed medications, were asked to participate in the study, and an interview was scheduled. Patients were asked to provide their complete medical and biochemical record from their general practitioner.<h4>Results</h4>509 patients, mean age 74.8±6.5 years, 57.4% female, participated in the study. 164 PIM were identified in 139 patients (27.3%). The most common were: long-term use of long-acting benzodiazepines (20.7%), use of non-steroidal antiinflammatory drugs (NSAID) in patients with moderate-severe hypertension (20.1%), use of theophylline as monotherapy for chronic obstructive pulmonary disease (COPD, 15.9%) and use of aspirin without appropriate indication (15.2%). Patients with more than four prescpritions had a higher risk for PIM (OR 2.85, 95% CI 1.97-4.14, p<0.001). There were 439 PPO, identified in 257, (50.5%) patients. Predictors for PPO were older age, presence of diabetes, myocardial infarction, osteoporosis, stroke, COPD and/or angina pectoris.<h4>Conclusion</h4>STOPP/START criteria may be useful in identifying inappropriate prescribing and improving the current prescribing practices. Pharmacists should focus more on patients with more than four medications and/or patients with gout or pain accompanied with arterial hypertension because those patient may be at higher risk of PIM. Additionlly, patients older than 74 years with diabetes, osteoporosis, myocardial infarction, stroke, angina pectoris and/or COPD may have an increased risk of PPO.
format	article
author	Sandra Vezmar Kovačević Mika Simišić Svetlana Stojkov Rudinski Milica Ćulafić Katarina Vučićević Milica Prostran Branislava Miljković
author_facet	Sandra Vezmar Kovačević Mika Simišić Svetlana Stojkov Rudinski Milica Ćulafić Katarina Vučićević Milica Prostran Branislava Miljković
author_sort	Sandra Vezmar Kovačević
title	Potentially inappropriate prescribing in older primary care patients.
title_short	Potentially inappropriate prescribing in older primary care patients.
title_full	Potentially inappropriate prescribing in older primary care patients.
title_fullStr	Potentially inappropriate prescribing in older primary care patients.
title_full_unstemmed	Potentially inappropriate prescribing in older primary care patients.
title_sort	potentially inappropriate prescribing in older primary care patients.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/3af9fd753b6146f19084184d4a20e83e
work_keys_str_mv	AT sandravezmarkovacevic potentiallyinappropriateprescribinginolderprimarycarepatients AT mikasimisic potentiallyinappropriateprescribinginolderprimarycarepatients AT svetlanastojkovrudinski potentiallyinappropriateprescribinginolderprimarycarepatients AT milicaculafic potentiallyinappropriateprescribinginolderprimarycarepatients AT katarinavucicevic potentiallyinappropriateprescribinginolderprimarycarepatients AT milicaprostran potentiallyinappropriateprescribinginolderprimarycarepatients AT branislavamiljkovic potentiallyinappropriateprescribinginolderprimarycarepatients
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Potentially inappropriate prescribing in older primary care patients.

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