Nieves-Pérez Bianca F, Hostos Sullynette Guerrero-De, Frontera-Hernández Mariela I, González Iadelisse Cruz, Muñoz José Josué Hernández
Consult Pharm. 2018 Nov 1;33(11):619-636. doi: 10.4140/TCP.n.2018.619..
Prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). Cross-sectional study through review of residents' records. Three nursing homes of Puerto Rico's metropolitan area. Nursing home residents. Records of residents 65 years of age and older with documented medications and chronic diseases were reviewed. Hospitalized and hospice/palliative care residents were excluded. Beers criteria-2015 and START-STOPP criteria-2014 were applied to identify PIMs and PPOs. Beers criteria versus STOPP criteria findings were compared. Prevalence of PIMs and PPOs in relation to residents' baseline characteristics. One hundred four records were reviewed. Categorical variables were analyzed by Fisher's exact test and chi square test; -tests established a relationship between variables and the prevalence of PIMs and PPOs. The quantity of PIMs was analyzed through frequency and percentage values. A statistically significant correlation was found between prescribed medications and PIMs detected using Beers criteria (-value = 0.031) and STOPP modified criteria (-value = 0.0002). No statistically significant data were obtained from the START criteria. Beers criteria were more effective identifying PIMs compared with STOPP criteria. The number of prescribed medications correlated directly to the number of identified PIMs. Additional studies where these tools are applied, and clinical pharmacist interventions are performed, should confirm an improved management of nursing home residents' drug therapy in Puerto Rico.
潜在不适当用药(PIMs)和潜在处方遗漏(PPOs)的患病率。通过查阅居民记录进行横断面研究。波多黎各大都市区的三家养老院。养老院居民。对65岁及以上有用药记录和慢性病记录的居民记录进行了查阅。排除住院患者和临终关怀/姑息治疗患者。应用2015年版《Beers标准》和2014年版《START-STOPP标准》来识别PIMs和PPOs。比较了《Beers标准》与《STOPP标准》的结果。PIMs和PPOs的患病率与居民基线特征的关系。共查阅了104份记录。分类变量通过Fisher精确检验和卡方检验进行分析;t检验确定了变量与PIMs和PPOs患病率之间的关系。通过频率和百分比值分析PIMs的数量。使用《Beers标准》(P值 = 0.031)和修改后的《STOPP标准》(P值 = 0.0002)检测到的处方药物与PIMs之间存在统计学显著相关性。从《START标准》未获得统计学显著数据。与《STOPP标准》相比,《Beers标准》在识别PIMs方面更有效。处方药物数量与识别出的PIMs数量直接相关。在应用这些工具并开展临床药师干预的其他研究中,应能证实波多黎各养老院居民药物治疗管理得到改善。