Evaluation of pharmacotherapy used on geriatric population in an institution of special regime with the screening tool of older persons’ potentially inappropriate prescriptions (STOPP) criteria
DOI:
https://doi.org/10.17533/udea.vitae.v23n1a08Keywords:
Elderly, potentially inappropriate prescribing, polypharmacy, medication errorsAbstract
Background: Geriatric patients represent a major challenge for appropriate prescription because they have significant changes in vital areas, multiple comorbidities among other things that encourage their fragility. In light of current evidence, the number of prescription errors increases with age and with the number of drugs USED, showing that people over 65 is at greater risk of medical error when more than 8 drugs are consumed. Objectives: To identify and describe the inappropriate medicines in elderly people in order to propose an institutional prescription guide based on the results of the application of the Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) assessment methodology. Methods: A cross-section observational study with a retrospective collection of information was carried out in order to identify the frequency of inappropriate prescriptions in 300 elderly patients that were over 65 years, with a consumption of more than 5 medications and applying the STOPP criteria. The study was made in a special regime medical institution, reviewing medical records and considering variables such as number of medications, indications, dosage, therapeutic duplication, interactions and contraindications, among others. Results: The principal diagnosis was hipertension (47%) followed by diabetes mellitus (10%) and other hypothyroidisms (4%).After applying the STOPP criteria to each of the medical records, it was found that 50.7% (152) of the studied population had at least one inappropriate prescription distributed as follows: 2 prescriptions had 4 STOPP criteria, 7 prescriptions had 3 STOPP criteria, 28 had 2 STOPP criteria and 115 had 1 STOPP criteria. Conclusions: It was found that half of the prescriptions have at least one inadequate prescribed criteria, being the most important the inappropriate use of not indicated drugs or without an indication. Finally, guidelines for the rational use of drugs in the elderly with every detail of this institution are proposed.
Downloads
References
Bregnhøj L, Thirstrup J, Kristensen M, Bjerrum L, Sonne J. Prevalence of inappropriate prescribing in primary
care. Pharm World Sci. 2007; 29(3): 109-115.
Hanlon J, Schmader E, Samsa P. A method for assessing drug therapy appropriateness. J Clin Epidemiol. 2007; 45: 1045-1051.
Zavaleta M, Castro L, Reyes I, López M, Bermúdez M. Prescription errors in a primary care university unit: urgency of pharmaceutical care in Mexico. Braz. J. Med. Biol. Res. 2008; 44(1): 115-126.
MuathFahm, Hassan, Ghazali, AlRazzaq. Predictors of polypharmacy and adverse drug reactions among geriatric in patients at malaysian hospital. Health MED. 2010; 4(2): 273-285.
Christy W, Ledford A, Villagrana M, Kreps G, Zhao X, McHorneyb C, Weathers M, Keefe B. Patient perceptions of physician communication and the process of prescription. Patient Educ Couns. 2010; 80: 384-392.
Cahir C, Fahey T, Teeling M, Teljeur C. Medication errors: Definitions and classification. Br J ClinPharmacol 2010; 69(5): 543-52.
Aronson JK Fonte. Medication errors: definitions and classification. Br J ClinPharmacol 2009; 67(6): 599-604.
MuathFahmi, Hassan, Ghazali, AlRazzaq. Predictors of polypharmacy and adverse drug reactions among geriatric in patients at malaysian hospital. Health MED. 2010; 4(2): 273-285
Christy W, Ledford A, Villagrana M, Kreps G, Zhao X, McHorneybC, Weathers M, Keefe B. Patient perceptions of physician communication and the process of prescription. Patient Educ Couns 2010; 80: 384-392.
Escuela Andaluza de Salud Publica. Aproximación del tratamiento farmacológico en ancianos. 2011. [actualización Abril 2011; Fecha de acceso 16 de Junio de 2012] Disponible en: http://www. easp.es/web/documentos/MBTA/00001176documento.pdf 2012.
Hughes, Sue. Thrombosis Guidelines Provide Weak Recommendation of Aspirin. 2012 [actualización: Enero de 2012; Fecha de acceso: 13 de Marzo de 2012] Disponible en: http://www.medscape.org/viewarticle/759145?src=cmemp.
Erviti J. Problemas óseos asociados al uso de bifosfonatos: ¿Evitan o producen fracturas? BIT. 2009; 17(5): 65-84
López J, Vacca C. En: Propuesta para la implementación y desarrollo de programas de seguimiento farmacoterapéutico a personas con patologías crónicas, coordinador. Departamento de Farmacia. Universidad Nacional de Colombia. 2009. 1-83 p.
OlivenaA, Michalakea I, Zalmana D, Dormana E, Yeshurunb D, Odeha M. Prevention of prescription errors by computerized, on-line surveillance of drug order entry. Int J Med Inform .2005; 74: 377-386.
Holguín E, Orozco J. Medicación potencialmente inapropiada en ancianos en un hospital de primer nivel, Bogotá. Rev. Salud Pública. 2010; 12(2): 287-299.
Villalobos A, Cheng T, Martínez K, Torres P, Hernández L, Flores G. El error médico en la prescripción de medicamentos y el impacto de una intervención educativa. Bol Med Hosp Infant Mex. 2007; 64: 83-91.
WHO. Introduction to Drug Utilization Research En: WHO International Worling Group for Drug Statistics Methodology. Oslo Norway. 2003. 4-49 p.
O’Mahonya D, Gallagher P, Ryan C, Byrne C, Hamilton H, Barry P, O’Connor M. STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age. European Geriatric Medicine. 2010; 1: 45-51
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2016 Vitae
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright Notice and Open Access Statement
The Journal Vitae works under the Open Access license, and the published manuscripts remain available for the public, both on the Journal's website and in databases, under the Creative Commons license, "Noncommercial Attribution" and "Share alike" systems, adopted in Colombia. Hence, when the authors agree to publish in the Journal Vitae, they will not have the right to economic retributions on publications and reproductions through different diffusion media. The documents are freely available to the internet public, permitting users to read, download, copy, distribute, print, search, or link to the full texts and pass them as data to software. The only constraint on reproduction and distribution, should be to give authors control over the integrity of their work and the right to be appropriately acknowledged and cited.
Authors declare that:
-
They are the intellectual property owners and are responsible for all the information stated in the article.
-
This manuscript has not been submitted or published in other printed or digital media. They accept the responsibility for the judgments, opinions, and points of view expressed in the published article and, therefore, they exonerate Universidad de Antioquia and Journal Vitae from any process.
-
They exempt Universidad de Antioquia and Journal Vitae from settling conflicts or disputes related to the authorship of the referred article.
-
They accept the revision of the original manuscript by suitable personnel, and they bind themselves to perform the corrections appointed or suggested by the assessors.
-
Therefore, they know the editorial process and will not bind the Editorial Board of the Journal to assume any obligations regarding the volume and issue in which the article is published.
-
They transfer the rights of publication, reprinting, and distribution of the article from the moment of its approval, in print and digital format, without the right to economic rewards, and under the licensing conditions considered relevant by Journal Vitae.
-
They fully authorize Universidad de Antioquia and Journal Vitae to submit the published material to the diverse databases and indexing systems where the Journal can be found to comply with the requirements of the regulatory authorities to maintain the national classification of journals.
-
They will assume the article publication costs established for the current issue, and they will make the payment as soon as they are informed about the volume and the issue in which the final version of the article is published.
-
After the article is published, you can share digital or printed copies in a noncommercial manner. You will be able to use the paper in your institution or company for educational or research purposes, including the use in course programs.
Conflict of interest: Authors are responsible for recognizing and disclosing any financial or other benefits that could be perceived to bias their work, acknowledging all financial support and any personal connections with potential sponsors. Examples of such conflicts include receiving research funds or honoraria, serving on advisory boards, stock ownership, or employment and consulting arrangements. Authors without such connections should clearly state that they have no financial support or personal relationships that could be perceived to bias their work. All conflicts of interest should be disclosed on the author's identification page of the manuscript.