Skip to main content
Erschienen in: International Journal of Clinical Pharmacy 1/2015

01.02.2015 | Research Article

The impact of hospitalization on potentially inappropriate prescribing in an acute medical geriatric division

verfasst von: Dvora Frankenthal, Yaffa Lerman, Yehuda Lerman

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Background Screening Tool of Older Person’s Prescriptions (STOPP) and the Screening Tool to Alert doctors to Right Treatment (START) have been increasingly used to evaluate potentially inappropriate prescriptions (PIPs) and potentially prescription omissions (PPOs). The impact of hospitalization on PIPs/PPOs has not been investigated in depth. Objective To compare the prevalence of PIPs/PPOs in elderly patients on hospital admission and discharge and to identify associated risk factors. Setting An acute medical geriatric division of the Tel Aviv Medical Center (Israel). Method This retrospective cross-sectional study included patients admitted from 12/2011 to 12/2012 aged ≥65 years. Data from patients’ records included demographic details, diagnoses and medications at admission and discharge. STOPP/START criteria were applied to each patient’s record. Main outcome measure Prevalence of PIPs/PPOs on hospital admission and discharge. Results Three hundred patients were included (mean ± SD age 81.9 ± 7.2 years). Admission PIPs prevalence was 39.3 % (118 patients, 172 PIPs) and it increased to 46.0 % (138 patients, 209 PIPs) at discharge (P = 0.009). Admission PPOs prevalence was 41.0 % (123 patients, 153 PPOs) and it decreased to 28.3 % (85 patients, 99 PPOs) at discharge (P < 0.001). Having at least one PIP/PPO at discharge but not at admission was associated with length of hospital stay (OR 1.02, 95 % CI 1.001–1.03). History of falls increased the risk of being a “new PIP patient” (OR 2.25, 95 % CI 1.03–4.9), whereas diabetes increased the risk of being a “new PPO patient” (OR 3.86, 95 % CI 1.2–12.5). Conclusion Hospitalization in a geriatric division resulted in an increase in PIPs and a decrease in PPOs. Strategies to reduce PIPs need to be implemented, especially for patients with longer hospital stay and a history of falls.
Literatur
1.
Zurück zum Zitat Hamilton HJ, Gallagher PF, O’Mahony D. Inappropriate prescribing and adverse drug events in older people. BMC Geriatr. 2009;28(9):5.CrossRef Hamilton HJ, Gallagher PF, O’Mahony D. Inappropriate prescribing and adverse drug events in older people. BMC Geriatr. 2009;28(9):5.CrossRef
2.
Zurück zum Zitat Barry PJ, Gallagher P, Ryan C, O’mahony D. START (screening tool to alert doctors to the right treatment)—an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing. 2007;36:632–8.PubMedCrossRef Barry PJ, Gallagher P, Ryan C, O’mahony D. START (screening tool to alert doctors to the right treatment)—an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing. 2007;36:632–8.PubMedCrossRef
3.
Zurück zum Zitat O’Connor MN, Gallagher P, O’Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging. 2012;29(6):437–52.PubMedCrossRef O’Connor MN, Gallagher P, O’Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging. 2012;29(6):437–52.PubMedCrossRef
4.
Zurück zum Zitat Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008;46:72–83.PubMedCrossRef Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008;46:72–83.PubMedCrossRef
5.
Zurück zum Zitat Onatade R, Auyeung V, Scutt G, Fernando J. Potentially inappropriate prescribing in patients on admission and discharge from an older peoples’ unit of an acute UK hospital. Drugs Aging. 2013;30:729–37.PubMedCrossRef Onatade R, Auyeung V, Scutt G, Fernando J. Potentially inappropriate prescribing in patients on admission and discharge from an older peoples’ unit of an acute UK hospital. Drugs Aging. 2013;30:729–37.PubMedCrossRef
6.
Zurück zum Zitat Lang PO, Vogt-Ferrier N, Hasso Y, Le Saint L, Dramé M, Zekry D, et al. Interdisciplinary geriatric and psychiatric care reduces potentially inappropriate prescribing in the hospital: interventional study in 150 acutely ill elderly patients with mental and somatic comorbid conditions. J Am Med Dir Assoc. 2012;13:406.e1–7.CrossRef Lang PO, Vogt-Ferrier N, Hasso Y, Le Saint L, Dramé M, Zekry D, et al. Interdisciplinary geriatric and psychiatric care reduces potentially inappropriate prescribing in the hospital: interventional study in 150 acutely ill elderly patients with mental and somatic comorbid conditions. J Am Med Dir Assoc. 2012;13:406.e1–7.CrossRef
7.
Zurück zum Zitat Liu CL, Peng LN, Chen YT, Lin MH, Liu LK, Chen LK. Potentially inappropriate prescribing (IP) for elderly medical inpatients in Taiwan: a hospital-based study. Arch Gerontol Geriatr. 2012;55:148–51.PubMedCrossRef Liu CL, Peng LN, Chen YT, Lin MH, Liu LK, Chen LK. Potentially inappropriate prescribing (IP) for elderly medical inpatients in Taiwan: a hospital-based study. Arch Gerontol Geriatr. 2012;55:148–51.PubMedCrossRef
8.
Zurück zum Zitat Lang PO, Hasso Y, Dramé M, Vogt-Ferrier N, Prudent M, Gold G, et al. Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities. Age Ageing. 2010;39:373–81.PubMedCrossRef Lang PO, Hasso Y, Dramé M, Vogt-Ferrier N, Prudent M, Gold G, et al. Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities. Age Ageing. 2010;39:373–81.PubMedCrossRef
9.
Zurück zum Zitat Mansur N, Weiss A, Beloosesky Y. Is there an association between inappropriate prescription drug use and adherence in discharged elderly patients? Ann Pharmacother. 2009;43:177–84.PubMed Mansur N, Weiss A, Beloosesky Y. Is there an association between inappropriate prescription drug use and adherence in discharged elderly patients? Ann Pharmacother. 2009;43:177–84.PubMed
10.
Zurück zum Zitat Bakken MS, Ranhoff AH, Engeland A, Ruths S. Inappropriate prescribing for older people admitted to an intermediate-care nursing home unit and hospital wards. Scand J Prim Health Care. 2012;30:169–75.PubMedCentralPubMedCrossRef Bakken MS, Ranhoff AH, Engeland A, Ruths S. Inappropriate prescribing for older people admitted to an intermediate-care nursing home unit and hospital wards. Scand J Prim Health Care. 2012;30:169–75.PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Laroche ML, Charmes JP, Nouaille Y, Fourrier A, Merle L. Impact of hospitalisation in an acute medical geriatric unit on potentially inappropriate medication use. Drugs Aging. 2006;23:49–59.PubMedCrossRef Laroche ML, Charmes JP, Nouaille Y, Fourrier A, Merle L. Impact of hospitalisation in an acute medical geriatric unit on potentially inappropriate medication use. Drugs Aging. 2006;23:49–59.PubMedCrossRef
12.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.PubMedCrossRef Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.PubMedCrossRef
13.
Zurück zum Zitat Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist. 1970;10:20–30.PubMedCrossRef Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist. 1970;10:20–30.PubMedCrossRef
14.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef
15.
Zurück zum Zitat Gallagher P, Omahony D. STOPP (Screening tool of older persons’ potentially inappropriate prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing. 2008;37:673–9.PubMedCrossRef Gallagher P, Omahony D. STOPP (Screening tool of older persons’ potentially inappropriate prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing. 2008;37:673–9.PubMedCrossRef
16.
Zurück zum Zitat Wahab MS, Nyfort-Hansen K, Kowalski SR. Inappropriate prescribing in hospitalised Australian elderly as determined by the STOPP criteria. Int J Clin Pharm. 2012;34:855–62.PubMedCrossRef Wahab MS, Nyfort-Hansen K, Kowalski SR. Inappropriate prescribing in hospitalised Australian elderly as determined by the STOPP criteria. Int J Clin Pharm. 2012;34:855–62.PubMedCrossRef
17.
Zurück zum Zitat Gallagher P, Lang PO, Cherubini A, Topinková E, Cruz-Jentoft A, Montero Errasquín B, et al. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol. 2011;67:1175–88.PubMedCrossRef Gallagher P, Lang PO, Cherubini A, Topinková E, Cruz-Jentoft A, Montero Errasquín B, et al. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol. 2011;67:1175–88.PubMedCrossRef
18.
Zurück zum Zitat Kane RL, Quslander JG, Abrass IB, Resnick B. Essentials of clinical geriatrics. 6th ed. New York: McGraw-Hill; 2009. Kane RL, Quslander JG, Abrass IB, Resnick B. Essentials of clinical geriatrics. 6th ed. New York: McGraw-Hill; 2009.
19.
Zurück zum Zitat Morandi A, Vasilevskis E, Pandharipande PP, Girard TD, Solberg LM, Neal EB, et al. Inappropriate medication prescriptions in elderly adults surviving an intensive care unit hospitalization. J Am Geriatr Soc. 2013;61:1128–34.PubMedCentralPubMedCrossRef Morandi A, Vasilevskis E, Pandharipande PP, Girard TD, Solberg LM, Neal EB, et al. Inappropriate medication prescriptions in elderly adults surviving an intensive care unit hospitalization. J Am Geriatr Soc. 2013;61:1128–34.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Kanaan AO, Donovan JL, Duchin NP, Field TS, Tjia J, Cutrona SL, et al. Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers criteria medications. J Am Geriatr Soc. 2013;61:1894–9.PubMedCrossRef Kanaan AO, Donovan JL, Duchin NP, Field TS, Tjia J, Cutrona SL, et al. Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers criteria medications. J Am Geriatr Soc. 2013;61:1894–9.PubMedCrossRef
21.
Zurück zum Zitat Lam MP, Cheung BM. The use of STOPP/START criteria as a screening tool for assessing the appropriateness of medications in the elderly population. Expert Rev Clin Pharmacol. 2012;5:187–97.PubMedCrossRef Lam MP, Cheung BM. The use of STOPP/START criteria as a screening tool for assessing the appropriateness of medications in the elderly population. Expert Rev Clin Pharmacol. 2012;5:187–97.PubMedCrossRef
22.
Zurück zum Zitat Dalleur O, Spinewine A, Henrard S, Losseau C, Speybroeck N, Boland B. Inappropriate prescribing and related hospital admissions in frail older persons according to the STOPP and START criteria. Drugs Aging. 2012;29:829–37.PubMedCrossRef Dalleur O, Spinewine A, Henrard S, Losseau C, Speybroeck N, Boland B. Inappropriate prescribing and related hospital admissions in frail older persons according to the STOPP and START criteria. Drugs Aging. 2012;29:829–37.PubMedCrossRef
23.
Zurück zum Zitat Hill-Taylor B, Sketris I, Hayden J, Byrne S, O’Sullivan D, Christie R. Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact. J Clin Pharm Ther. 2013;38:360–72.PubMedCrossRef Hill-Taylor B, Sketris I, Hayden J, Byrne S, O’Sullivan D, Christie R. Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact. J Clin Pharm Ther. 2013;38:360–72.PubMedCrossRef
Metadaten
Titel
The impact of hospitalization on potentially inappropriate prescribing in an acute medical geriatric division
verfasst von
Dvora Frankenthal
Yaffa Lerman
Yehuda Lerman
Publikationsdatum
01.02.2015
Verlag
Springer Netherlands
Erschienen in
International Journal of Clinical Pharmacy / Ausgabe 1/2015
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-014-0040-9

Weitere Artikel der Ausgabe 1/2015

International Journal of Clinical Pharmacy 1/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.