Factors associated to potentially inappropriate prescribing in older patients according to STOPP/START criteria: MoPIM multicentre cohort study

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  • dc.contributor.author Baré, Marisa
  • dc.contributor.author Lleal, Marina
  • dc.contributor.author Ortonobes, Sara
  • dc.contributor.author Queralt Gorgas, Maria
  • dc.contributor.author Sevilla-Sánchez, Daniel
  • dc.contributor.author Carballo Martínez, Núria
  • dc.contributor.author de Jaime Gil, Elisabet
  • dc.contributor.author Herranz, Susana
  • dc.contributor.author MoPIM study group
  • dc.date.accessioned 2022-08-01T14:23:14Z
  • dc.date.available 2022-08-01T14:23:14Z
  • dc.date.issued 2022
  • dc.description.abstract Objectives: The objectives of the present analyses are to estimate the frequency of potentially inappropriate prescribing (PIP) at admission according to STOPP/START criteria version 2 in older patients hospitalised due to chronic disease exacerbation as well as to identify risk factors associated to the most frequent active principles as potentially inappropriate medications (PIMs). Methods: A multicentre, prospective cohort study including older patients (≥65) hospitalized due to chronic disease exacerbation at the internal medicine or geriatric services of 5 hospitals in Spain between September 2016 and December 2018 was conducted. Demographic and clinical data was collected, and a medication review process using STOPP/START criteria version 2 was performed, considering both PIMs and potential prescribing omissions (PPOs). Primary outcome was defined as the presence of any most frequent principles as PIMs, and secondary outcomes were the frequency of any PIM and PPO. Descriptive and bivariate analyses were conducted on all outcomes and multilevel logistic regression analysis, stratified by participating centre, was performed on the primary outcome. Results: A total of 740 patients were included (mean age 84.1, 53.2% females), 93.8% of them presenting polypharmacy, with a median of 10 chronic prescriptions. Among all, 603 (81.5%) patients presented at least one PIP, 542 (73.2%) any PIM and 263 (35.5%) any PPO. Drugs prescribed without an evidence-based clinical indication were the most frequent PIM (33.8% of patients); vitamin D supplement in older people who are housebound or experiencing falls or with osteopenia was the most frequent PPO (10.3%). The most frequent active principles as PIMs were proton pump inhibitors (PPIs) and benzodiazepines (BZDs), present in 345 (46.6%) patients. This outcome was found significantly associated with age, polypharmacy and essential tremor in an explanatory model with 71% AUC. Conclusions: PIMs at admission are highly prevalent in these patients, especially those involving PPIs or BZDs, which affected almost half of the patients. Therefore, these drugs may be considered as the starting point for medication review and deprescription.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Baré M, Lleal M, Ortonobes S, Gorgas MQ, Sevilla-Sánchez D, Carballo N, De Jaime E, Herranz S; MoPIM study group. Factors associated to potentially inappropriate prescribing in older patients according to STOPP/START criteria: MoPIM multicentre cohort study. BMC Geriatr. 2022 Jan 11;22(1):44. DOI: 10.1186/s12877-021-02715-8
  • dc.identifier.doi http://dx.doi.org/10.1186/s12877-021-02715-8
  • dc.identifier.issn 1471-2318
  • dc.identifier.uri http://hdl.handle.net/10230/53897
  • dc.language.iso eng
  • dc.publisher BioMed Central
  • dc.relation.ispartof BMC Geriatr. 2022 Jan 11;22(1):44
  • dc.rights © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Potentially inappropriate prescribing
  • dc.subject.keyword STOPP/START version 2
  • dc.subject.keyword Older patient
  • dc.subject.keyword Polypharmacy
  • dc.title Factors associated to potentially inappropriate prescribing in older patients according to STOPP/START criteria: MoPIM multicentre cohort study
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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