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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
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[Inappropriate prescription in elderly inpatients]
Ana V Fajreldines1, Jorge T Insua2, Eduardo Schnitzler3
1Departamento de Calidad y Seguridad del Paciente, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina.
Medicina
|December 14, 2016
Summary
Inappropriate prescriptions (PIM) are common in older adults, leading to adverse drug events (EAM). These events increase hospitalization costs, highlighting the need for better prescribing practices in geriatric care.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Health Economics
Background:
- Preventable adverse drug events (EAM) are a significant concern in older adults.
- Inappropriate prescribing (PIM), where risks exceed benefits, is a major cause of EAM.
- Existing tools like Beers criteria, STOPP, and START aim to identify and reduce PIM.
Purpose of the Study:
- To determine the incidence of PIM using Beers criteria and STOPP/START tools.
- To assess the incidence of EAM in hospitalized older adults.
- To analyze the association between PIM, EAM, and hospitalization costs.
Main Methods:
- An incidence study conducted on patients over 64 years old hospitalized between January and July 2014.
- Utilized Beers criteria, Screening Tool of Older Person's Prescriptions (STOPP), and Screening Tool to Alert Doctors to Right Treatments (START) for PIM assessment.
- Calculated EAM rates per 100 admissions and per 1000 patient days.
Main Results:
- PIM incidence was 61.4% (Beers), 65.4% (STOPP), and 27.6% (START).
- EAM rate was 15.2/100 admissions and 18.6 EAM/1000 patient days.
- Hospitalization costs were significantly higher for patients experiencing EAM (p = 0.020).
Conclusions:
- PIM is prevalent in older hospitalized patients and contributes to EAM.
- The incidence of PIM and EAM found in this study aligns with, and in some cases exceeds, previous research.
- Reducing PIM is crucial for preventing EAM and mitigating associated healthcare costs in the elderly.
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