Aziz Victor M, Hill Natalie, Kumar Sugandha
Cynon Valley Hospital,Wales.
Wales Deanery,Cardiff.
BJPsych Bull. 2018 Feb;42(1):37-41. doi: 10.1192/bjb.2017.10.
Aims and method To explore the use of the STOPP/START toolkit in older psychiatric in-patients with dementia. Clinical records and current drug charts were reviewed against STOPP/START criteria for all in-patients (n = 86) on six specialist dementia wards.
Benzodiazepines, antipsychotics and opiates were most commonly prescribed inappropriately. The most common unprescribed medication groups were statins, calcium supplements and vitamin D supplements. There was an overall reduction of 7% in comorbidities and 8% in the number of prescriptions. t-test showed a significant drop in average comorbidities between both audits, t(1) = 23.920, P = 0.027, and in average prescriptions per patient, t(1) = 28.808, P = 0.022. There was no difference in the number of patients receiving polypharmacy, t(1) = 7.500, P = 0.084, or receiving medication with a high risk of adverse drug reactions, t(1) = 6.857, P = 0.092. Clinical implications The STOPP/START toolkit highlighted the importance of collaborative working between doctors, clinical pharmacists and nursing staff, and could provide old age psychiatrists with a structured tool to identify inappropriate prescribing of non-psychiatric medications. Declaration of interests None.
目的与方法 探讨STOPP/START工具包在老年痴呆症住院精神科患者中的应用。根据STOPP/START标准，对六个专科痴呆症病房的所有住院患者（n = 86）的临床记录和当前药物图表进行了审查。
苯二氮䓬类药物、抗精神病药物和阿片类药物的处方不当最为常见。最常见的未开处方药物类别是他汀类药物、钙补充剂和维生素D补充剂。合并症总体减少了7%，处方数量减少了8%。t检验显示，两次审核之间平均合并症有显著下降，t(1) = 23.920，P = 0.027，每位患者的平均处方数也有显著下降，t(1) = 28.808，P = 0.022。接受多种药物治疗的患者数量没有差异，t(1) = 7.500，P = 0.084，或接受有高药物不良反应风险药物治疗的患者数量也没有差异，t(1) = 6.857，P = 0.092。临床意义 STOPP/START工具包强调了医生、临床药剂师和护理人员之间协作的重要性，并可为老年精神科医生提供一个结构化工具，以识别非精神科药物的不适当处方。利益声明 无。
