Costs of medication in older patients: before and after comprehensive geriatric assessment

Gulcin Done Unutmaz,1 Pinar Soysal,2 Busra Tuven,1 Ahmet Turan Isik3 1Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Geriatric Center Kayseri Education and Research Hospital, Kayseri, Turkey; 3Department of Geriatric Medicine, Faculty of Medicine, Doku...

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Autores principales:	Unutmaz GD, Soysal P, Tuven B, Isik AT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Cost Comprehensive Geriatric Assessment Polypharmacy Elderly Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/5b81038f488e4ed3984d00d1b1a4af74
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spelling	oai:doaj.org-article:5b81038f488e4ed3984d00d1b1a4af742021-12-02T07:36:56ZCosts of medication in older patients: before and after comprehensive geriatric assessment1178-1998https://doaj.org/article/5b81038f488e4ed3984d00d1b1a4af742018-04-01T00:00:00Zhttps://www.dovepress.com/costs-of-medication-in-older-patients-before-and-after-comprehensive-g-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Gulcin Done Unutmaz,1 Pinar Soysal,2 Busra Tuven,1 Ahmet Turan Isik3 1Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Geriatric Center Kayseri Education and Research Hospital, Kayseri, Turkey; 3Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Background: Polypharmacy and inappropriate drug use cause numerous complications, such as cognitive impairment, frailty, falls, and functional dependence. The present study aimed to determine the effect of the comprehensive geriatric assessment (CGA) on polypharmacy, potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), and to evaluate the economic reflections of medication changes.Methods: One thousand five hundred and seventy-nine older patients, who had undergone CGA, were retrospectively evaluated. The drugs, drug groups, and number of drugs that the patients used were recorded. Appropriate drug therapy was identified by both CGA and STOPP/START criteria. Based on these criteria, PIMs were discontinued and PPOs were started. The monthly cost of these drugs was calculated separately for PIMs and PPOs by using the drugstore records.Results: After CGA, while the prevalence of non-polypharmacy was increased from 43.3% to 65.6%, the prevalence of polypharmacy and hyperpolypharmacy was decreased from 56.7% to 34.4% and 12.0% to 3.6%, respectively. The three most common PIMs discontinued were proton pump inhibitors, anti-dementia drugs, and antipsychotics, respectively. However, the most common PPOs started were vitamin D and B12 supplements, and anti-depressants. After CGA, monthly saved total per capita cost of PIMs was US$12.8 and monthly increased total per capita cost of PPOs was $5.6.Conclusion: It was demonstrated that prevalence of polypharmacy, PIM, and PPO could be decreased by CGA including START/STOPP criteria in older adults. Furthermore, this will have beneficial effects on economical parameters due to decreasing drug-related health care costs. Keywords: cost, comprehensive geriatric assessment, polypharmacy, elderlyUnutmaz GDSoysal PTuven BIsik ATDove Medical PressarticleCostComprehensive Geriatric AssessmentPolypharmacyElderlyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 607-613 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cost Comprehensive Geriatric Assessment Polypharmacy Elderly Geriatrics RC952-954.6
spellingShingle	Cost Comprehensive Geriatric Assessment Polypharmacy Elderly Geriatrics RC952-954.6 Unutmaz GD Soysal P Tuven B Isik AT Costs of medication in older patients: before and after comprehensive geriatric assessment
description	Gulcin Done Unutmaz,1 Pinar Soysal,2 Busra Tuven,1 Ahmet Turan Isik3 1Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; 2Geriatric Center Kayseri Education and Research Hospital, Kayseri, Turkey; 3Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey Background: Polypharmacy and inappropriate drug use cause numerous complications, such as cognitive impairment, frailty, falls, and functional dependence. The present study aimed to determine the effect of the comprehensive geriatric assessment (CGA) on polypharmacy, potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), and to evaluate the economic reflections of medication changes.Methods: One thousand five hundred and seventy-nine older patients, who had undergone CGA, were retrospectively evaluated. The drugs, drug groups, and number of drugs that the patients used were recorded. Appropriate drug therapy was identified by both CGA and STOPP/START criteria. Based on these criteria, PIMs were discontinued and PPOs were started. The monthly cost of these drugs was calculated separately for PIMs and PPOs by using the drugstore records.Results: After CGA, while the prevalence of non-polypharmacy was increased from 43.3% to 65.6%, the prevalence of polypharmacy and hyperpolypharmacy was decreased from 56.7% to 34.4% and 12.0% to 3.6%, respectively. The three most common PIMs discontinued were proton pump inhibitors, anti-dementia drugs, and antipsychotics, respectively. However, the most common PPOs started were vitamin D and B12 supplements, and anti-depressants. After CGA, monthly saved total per capita cost of PIMs was US$12.8 and monthly increased total per capita cost of PPOs was $5.6.Conclusion: It was demonstrated that prevalence of polypharmacy, PIM, and PPO could be decreased by CGA including START/STOPP criteria in older adults. Furthermore, this will have beneficial effects on economical parameters due to decreasing drug-related health care costs. Keywords: cost, comprehensive geriatric assessment, polypharmacy, elderly
format	article
author	Unutmaz GD Soysal P Tuven B Isik AT
author_facet	Unutmaz GD Soysal P Tuven B Isik AT
author_sort	Unutmaz GD
title	Costs of medication in older patients: before and after comprehensive geriatric assessment
title_short	Costs of medication in older patients: before and after comprehensive geriatric assessment
title_full	Costs of medication in older patients: before and after comprehensive geriatric assessment
title_fullStr	Costs of medication in older patients: before and after comprehensive geriatric assessment
title_full_unstemmed	Costs of medication in older patients: before and after comprehensive geriatric assessment
title_sort	costs of medication in older patients: before and after comprehensive geriatric assessment
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/5b81038f488e4ed3984d00d1b1a4af74
work_keys_str_mv	AT unutmazgd costsofmedicationinolderpatientsbeforeandaftercomprehensivegeriatricassessment AT soysalp costsofmedicationinolderpatientsbeforeandaftercomprehensivegeriatricassessment AT tuvenb costsofmedicationinolderpatientsbeforeandaftercomprehensivegeriatricassessment AT isikat costsofmedicationinolderpatientsbeforeandaftercomprehensivegeriatricassessment
_version_	1718399337255403520

Costs of medication in older patients: before and after comprehensive geriatric assessment

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