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Candeias C, Gama J, Rodrigues M, Falcão A, Alves G. Potentially Inappropriate Medications and Potential Prescribing Omissions in Elderly Patients Receiving Post-Acute and Long-Term Care: Application of Screening Tool of Older People's Prescriptions/Screening Tool to Alert to Right Treatment Criteria. Front Pharmacol 2021; 12:747523. [PMID: 34737705 PMCID: PMC8560892 DOI: 10.3389/fphar.2021.747523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Screening Tool of Older People's Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START) criteria have been used to detect potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). These criteria were applied to geriatric Portuguese patients receiving post-acute and long-term care to assess the prevalence and predictors of PIMs and PPOs. Methods: An observational, retrospective, cross-sectional and multicenter study was performed in 161 patients (aged ≥65 years) from eight Units for Integrated Continuous Care. Results: In these studied patients (mean age: 81.6, 64% female, median number of medications: 9) PIMs were detected in 85.1% and PPOs in 81.4% of patients. While PIMs mainly involved the central nervous system and psychotropic drugs (66.5%), PPOs were mostly related to musculoskeletal system (55.3%) and cardiovascular (39.8%) system. A subsequent analysis with logistic regression found the female gender, the hospital provenience, and the number of medications as predictors of PIMs. Predictors of PPOs were the Charlson Comorbidity Index and history of recent fractures. Conclusion: PIMs and PPOs were highly prevalent in the studied patients receiving post-acute and long-term care in Units for Integrated Continuous Care. Therefore, STOPP/START criteria might be an effective tool for improving prescribing quality and clinical outcomes in these frail elderly patients.
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Affiliation(s)
- Catarina Candeias
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,UMP-Union of Portuguese Mercies, Lisboa, Portugal
| | - Jorge Gama
- CMA-UBI-Centre of Mathematics and Applications, University of Beira Interior, Covilhã, Portugal
| | - Márcio Rodrigues
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,ESALD-IPCB-Dr. Lopes Dias School of Health, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal.,UDI-IPG-Research Unit for Inland Development, Polytechnic Institute of Guarda, Guarda, Portugal
| | - Amílcar Falcão
- CIBIT-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal.,Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Gilberto Alves
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.,ESALD-IPCB-Dr. Lopes Dias School of Health, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal.,UFBI-Pharmacovigilance Unit of Beira Interior, University of Beira Interior, Covilhã, Portugal
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