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Intervention study design by pharmacists to doctors using face-to-face interviews conducted in this study aimsto analyze potentially inappropriate medications (PIMs) with prospective data collection in the geriatric ward ofRegional General Hospital Dr.M. M. Dunda Gorontalo, Indonesia in the period from January to March 2018. Thesampling technique was a total sampling design and obtained by the end of the study were 123 patients. Results ofanalysis with Beers and screening tool of older people’s prescriptions (STOPP) from 123 patients found 54 PIMs in48 patients (39.0%) based on Beers criteria and 6 patients (6.3%) based on STOPP criteria. Bivariate analysis showedthat there was a significant relationship between the incidence of adverse drug events (ADEs), with unresolved PIMswith a relative risk value at 1.55 (95% CI 1.26:1.91), p = 0.007 and a correlation coefficient (r) of 0.332. Based on theresults of univariate and bivariate statistical analysis, it can be concluded that there are still many PIMs occurring inthe prescription of geriatric patients based on Beers and STOPP criteria and pharmacists have a large enough role toreduce the incidence of PIMs so that the prevalence of ADEs due to inappropriate use of the drug can be minimized atRegional General Hospital Dr. M. M. Dunda Gorontalo, Indonesia.
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Background: Prescribing in elderly is a challenging task as they have age related physiological changes, various co-morbidities, altered pharmacological properties and higher propensity for adverse events. They are often prescribed medications which are potentially inappropriate for them, sometimes may even be unnecessary. The medicines are considered as inappropriate if the risk associated with them outweighs benefits. The objective of this study is to assess the prevalence of potentially inappropriate medications (PIM) at a tertiary care teaching hospital according to the Beers updated 2015 criteria and STOPP criteria and to compare the two criteria in detection of PIMs.Methods: A prospective observational study involving 228 elderly patients (>65years) of medicine wards was conducted from October 2015 to March 2016. Relevant information was recorded in a predesigned proforma. The use of potentially inappropriate medications is assessed using Beers updated 2015 criteria and STOPP criteria using descriptive statistics.Results: The prevalence of PIM use in the sample was 26.31% according to the 2015 Beers criteria and 14.03% using the STOPP criteria. The most prevalent PIM according to the Beers criteria were sliding scale insulin (17.54%) and long acting benzodiazepines (5.26%); according to the STOPP criteria, they were aspirin in heart failure (5.26%) and chlorpheniramine (3.07%).Conclusions: The prevalence of PIM varied when different criteria were applied. The 2015 Beers criteria identified more PIM than the STOPP criteria.
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Introduction: Polypharmacy is the practice of prescribing many medications. In this study, we assessed the current status of polypharmacy among elderly patients and cases of inappropriate prescription (IP) at the Department of General Internal Medicine (GIM) at Sendai Medical Center.Methods: We retrospectively surveyed 136 inpatients who were over 65 years old between April 2015 and March 2016 at the Department of GIM.We examined the patient's current medications and used the STOPP (screening tool of older person's potentially inappropriate prescriptions) criteria version 2 to analyze potentially inappropriate medication (PIM) cases.Results: Of 136 study patients, 77 (56.6%) patients were taking more than 6 medications. For patients over 75 years old, the average number of current medications increased.In addition, 33 cases of PIM were confirmed and the number increased in proportion to the number of current medications. Furthermore, there were 4 cases of adverse reactions in which the STOPP criteria version 2 were not applied.Conclusion: In this study, we confirmed polypharmacy in the examined patients.In order to solve the problem of polypharmacy, all medical staff must cooperate and review the prescriptions of individual patients.General physicians should assume the leading role in the distribution and improvement of polypharmacy and IP.
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ABSTRACT Management of pharmacotherapy in elderly with metabolic diseases is challenging and potentially inappropriate medications (PIMs) are risk factors for drug interactions and adverse events. The exposure to PIMs in elderly outpatients with metabolic diseases and its relationship with polypharmacy and other variables was investigated. PIMs prescribed to 207 elderly patients (aged 60 to 96 years) with metabolic diseases who attended a University Hospital of Sao Paulo city, Brazil, from April/2010 to January/2011, were evaluated. PIMs were detected using both 2003 Beers and 2008 STOPP criteria. The association between PIMs and age, gender and polypharmacy was also examined. 2008 STOPP criteria detected more PIMs (44.4 %) than 2003 Beers criteria (16.0%, p<0.001). Beers detected mainly PIMs antihypertensive (clonidine, 20.0%; doxazosin, 10.0%) and antidepressant (fluoxetine, 15.0%; amitriptyline, 10.0%) PIMs. Medicines used for cardiovascular (aspirin, 53.7%) and endocrine system (glibenclamide, 21.3%) were PIMs more frequently detected by 2008 STOPP. Unlike age and gender, polypharmacy increased the risk of PIMs by both 2003 Beers (OR: 4.0, CI95%: 1.2-13.8, p<0.031) and 2008 STOPP (OR: 6.8, CI95%: 3.0-15.3, p<0.001). Beers and STOPP criteria are important tools to evaluate the exposure to PIMs, which is strongly associated with polypharmacy in elderly outpatients with metabolic diseases.