Abstract
This study was done to determine the incidence of polypharmacy – in males and females admitted in Tertiary care hospital and to determine the drugs most inappropriate prescribed as per START/STOPP criteria. A retrospective study was conducted in Department of Pharmacology in collaboration with medical records Department. 150 subjects were included of both male and female gender above the age of 60 years with co-morbidities, multiple prescriptions and only those who were compliant with medications. Pregnant women, post-operative patients and patients with a h/o of participation in trials in the least 6 months were not included. Data collection was done by accessing IPD files after obtaining permission from Medical Records Department. Patients will be divided in 2 categories of male and female. A list of their medications will be made and added in the Case Record form. The PIP indicator – STOPP/START was then be applied. After which since it is an exploratory study- descriptive analysis was be done.
Results: There was a high frequency of polypharmacy seen. In the recruited sample 44% were males and 56% were females. Proportion of patients receiving at least one potentially inappropriate medication (PIM) was 11.22%.Proportion of patients subjected to at least one potential prescribing omission (PPO) was 12.54%. Proportion of patients exposed to potentially inappropriate drug prescriptions as a whole (PIPs=PIMs+PPOs) was 23.76%.
References
- Bjerre, Lise M et al. "Assessing Potentially Inappropriate Prescribing (PIP) And Predicting Patient Outcomes in Ontario’S Older Population: A Population-Based Cohort Study Applying Subsets of the STOPP/START and Beers’ Criteria in Large Health Administrative Databases". BMJ Open 11 (2015): e010146.
- Wickop, Beate et al. "Potentially Inappropriate Medication Use in Multimorbid Elderly Inpatients: Differences Between The FORTA, PRISCUS And STOPP Ratings".Drugs - Real World Outcomes 3 (2016): 317-325.
- Howard, M. "Prescribing of Potentially Inappropriate Medications to Elderly People".Family Practice 3 (2004): 244-247.
- Hill-Taylor, B. et al. "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".Journal of Clinical Pharmacy and Therapeutics 5 (2013): 360-372.
- O'Mahony, D. et al. "STOPP/START Criteria for Potentially Inappropriate Prescribing in Older People: Version 2".Age and Ageing 2 (2014): 213-218.
- Won, Aida B. et al. "Persistent Nonmalignant Pain and Analgesic Prescribing Patterns in Elderly Nursing Home Residents".Journal of the American Geriatrics Society 6 (2004): 867-874.
- Frankenthal, Dvora et al. "Intervention with The Screening Tool Of Older Persons Potentially Inappropriate Prescriptions/ Screening Tool To Alert Doctors To Right Treatment Criteria In Elderly Residents Of A Chronic Geriatric Facility: A Randomized Clinical Trial".Journal of the American Geriatrics Society 9 (2014): 1658-1665.
- Rémillard, Alfred J. "A Pharmacoepidemiological Evaluation Of Anticholinergic Prescribing Patterns In The Elderly".Pharmacoepidemiology and Drug Safety 3 (1996): 155-164.
- STOPP/START Criteria Reduce Adrs And Drug Costs In Elderly".Reactions Weekly 1 (2016): 13-13.
- Cahir, Caitriona et al. "Potentially Inappropriate Prescribing And Cost Outcomes For Older People: A National Population Study".British Journal of Clinical Pharmacology 5 (2010): 543-552.
- Morgan, Steven G. et al. "Sex Differences In The Risk Of Receiving Potentially Inappropriate Prescriptions Among Older Adults".Age and Ageing 4 (2016): 535-542.
- Morgan, S. G. et al. "Frequency And Cost Of Potentially Inappropriate Prescribing For Older Adults: A Cross-Sectional Study".CMAJ Open 2 (2016): E346-E351. Web.
- Nolan, Lisa and Kevin O'Malley. "Prescribing For The Elderly: Part II Prescribing Patterns: Differences Due To Age".Journal of the American Geriatrics Society 3 (1988): 245-254.
- Straand, Jørund et al. "A Cluster-Randomized Educational Intervention To Reduce Inappropriate Prescription Patterns For Elderly Patients In General Practice – The Prescription Peer Academic Detailing (Rx-PAD) Study [NCT00281450]".BMC Health Services Research 1 (2006): n. page.
- Duque, Gustavo and Manual Montero-Odasso. "USE OF ANALGESICS IN ELDERLY NURSING HOME RESIDENTS". Journal of the American Geriatrics Society5 (2005): 909-909.
- .S. Karandikar, M.B.B.S., M.D *, S.R. Chaudhari, N.P. Dalal, M. Sharma,V.A. PanditInappropriate prescribing in the elderly: A comparison of twovalidated screening toolsY, Journal of Clinical Gerontology & Geriatrics 4 (2013) 109e114
- O’Mahony D, Gallagher P, Ryan C, Byrne SH, Hamilton H, Barry P, et al. STOPP & START criteria. A new approach to detecting potentially inappropriate prescribing in old age. EurGeriatr Med 2010;1:45e51.
- Gallagher P, O’Mahony D. STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions) application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing 2008;37:673e9.
- Gallagher PF, O’Connor MN, O’Mahony D. Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria. Clin PharmacolTher 2011;89:845e54.
- 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 2011;55:148e51.
- Barry PJ, O’Keefe N, O’Connor KA et al. Inappropriate prescribing in the elderly: a comparison ofthe Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalised patients. J Clin Pharm Ther 2006; 31: 617–26.
- 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.
- Lin HY, Liao CC, Cheng SH, Wang PC, Hsueh YS. Association of potentially inappropriate medication use with adverse outcomes in ambulatory elderly patients with chronic diseases: Experience in a Taiwanese medical setting. Drugs Aging 2008;25:49-59
- Veena D.R, Padma L, SapnaPatil. Drug prescribing pattern in elderly patients in a teaching hospital. IOSR Journal of Dental and Medical Sciences (JDMS). Volume 1, Issue 5 (Sep-Oct. 2012), PP 39-42
- Cooney D, Pascuzzi K. Polypharmacy in the elderly: focus on drug interactions and adherence in hypertension. ClinGeriatr Med 2009;25:221–33.
- Espino DV, Bazaldua OV, Palmer RF, et al. Suboptimal medication use and mortality in an older adult community based cohort: Results from the Hispanic EPESE Study. J Gerontol A BiolSci Med Sci. 2006;61:170-175.
- Berdot et al, Inappropriate medication use and risk of falls – A prospective study in a large community-dwelling elderly cohort, BMC Geriatr. 2009;
Corresponding Author
Yadav P
Professor, Dept. of Pharmacology, D.Y. Patil University, School of Medicine