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Published on: January 11, 2020
[Potentially inappropriate prescribing in patients over 65 years-old in a primary care health centre]
Naldy Parodi López1, Yuri Fabiola Villán Villán2, María Isabel Granados Menéndez3
1Medicina Familiar y Comunitaria, Centro de Salud Monóvar, Madrid, España.
Objective:
To identify potentially inappropriate prescriptions (PPI) and prescribing omissions (OP) by means of the STOPP/START criteria, as well as associated factors in ≥65year old patients in a Primary Care setting in Spain.
Study Design:
A cross-sectional, descriptive study.
Setting:
Centro de Salud Monóvar, Primary Health Care.
Study Period:
6months.
Patients Random Sample:
247patients.
Eligibility Criteria:
≥65years patients who attended an urban Primary Care clinic 2 or more times were studied. Terminally ill and nursing home residents were excluded.
Methods:
Data were collected from electronic clinical records. STOPP and START criteria were evaluated in each clinical record, including age, sex, co-morbidity, number of chronic prescriptions.
Main Outcomes:
PPI and OP identified by STOPP and START criteria, respectively.
Results:
A total of 81 patients (32.8%) had PPI, with the most common being the long-term use of long-acting benzodiazepines in 17 (6.9%). OP was found in 73 (29.6%) patients, with the most common being the omission of statins in patients diagnosed with diabetes mellitus and/or one or more major cardiovascular risk factors in 21 (8.5%). After adjustment by gender and age, correlations were found between PPI and multiple medication (OR: 2.02; 95%CI: 1.15-3.53; P=.014), and OP and polypharmacy (OR: 2.37; 95%CI: 1.32-4.24; P=0.004).
Conclusions:
Inappropriate prescribing in older people is frequent, and is mainly associated with long-acting benzodiazepines. There are diabetic patients who do not have statins prescribed. Multiple medication is associated with PPI and OP.
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