ABSTRACT
BACKGROUND: STOPP (Screening Tool of Older Person's Prescriptions) criteria have been used in acute care and nursing home settings as a screening tool to assess Potentially Inappropriate Medication (PIM) for elderly people. Furthermore, this tool could help General Practitioners (GPs) to lower PIM frequency in primary care. OBJECTIVE: The aim of the study was to measure the impact of STOPP criteria applied by the GP on prescriptions during a primary care consultation. SETTING, SUBJECTS AND METHOD: Twenty GPs were involved and trained to use STOPP criteria. GPs were asked to use STOPP criteria for elderly patients (>75years old) who were taking at least five different drugs, seen over a two-month period. The rate of PIM according to STOPP criteria was measured before and after training. Prescription quality was compared using the Medication Appropriateness Index (MAI) score. RESULTS: Overall, 172 prescriptions were analyzed. A total of 170 PIM were identified according to STOPP criteria before the intervention. Fifty-seven percent of the population (n=98 patients) had at least one PIM. GP's intervention decreased the number of PIM according to STOPP criteria to 106 and was beneficial for 44.9% of the patients (n=44). The mean MAI score of all medications and PIM decreased by 14.3% (p<0.001) and 39.1% (p<0.001) respectively. DISCUSSION CONCLUSIONS: Application of STOPP criteria by GPs is an effective tool to decrease PIM and MAI score in primary care. The generalization of the use of STOPP criteria during GP consultation should be fostered.
Subject(s)
General Practitioners/standards , Inappropriate Prescribing/prevention & control , Mass Screening/methods , Nursing Homes , Potentially Inappropriate Medication List/statistics & numerical data , Primary Health Care/standards , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Retrospective StudiesABSTRACT
AIM: Acetaminophen is widely used in hospital settings and often considered as nontoxic. We conducted a multicentric study in order to evaluate its proper use. METHOD: Prescriptions from five general hospitals were analyzed, according to dose adjustments required in renal or liver failure, weight or chronic alcoholism, determined using a literature review. Other criteria have been assessed: indication for parenteral access, accuracy of administration time and pain assessment. RESULTS: Among the 1256 analyzed prescriptions, 21% are non-compliants. The main causes of non-compliance (NC) are adjustments to weight and renal failure. Higher NC rates concern chronic alcoholism and liver failure. CONCLUSION: Misuse of acetaminophen seems related to a lack of official recommendations concerning dose adjustments. Hospital pharmacists have an important role to play in the promotion of proper use of acetaminophen. Therefore we established a prescribing aid.
Subject(s)
Acetaminophen/therapeutic use , Analgesics, Non-Narcotic/therapeutic use , Drug Prescriptions/statistics & numerical data , Aged , Aged, 80 and over , Drug Misuse/statistics & numerical data , Female , Hospitals/statistics & numerical data , Humans , Male , Prospective StudiesABSTRACT
The interaction between tamoxifen and antidepressants which are CYP2D6 inhibitors is unknown, as shown in our study in which these antidepressants are prescribed to 11% of women receiving tamoxifen.
