Kympers C, Tommelein E, Van Leeuwen Ellen, Boussery K, Petrovic M, Somers A
a Department of Internal medicine, section of Geriatrics, Faculty of Medicine and Health Sciences , Ghent University , Gent , Belgium.
b Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences , Ghent University , Gent , Belgium.
Acta Clin Belg. 2019 Apr;74(2):126-136. doi: 10.1080/17843286.2019.1568353. Epub 2019 Jan 30.
The Ghent Older People's Prescriptions community Pharmacy Screening (GheOPS-) tool was recently developed as an explicit screening method to detect Potentially Inappropriate Prescribing (PIP) in the community pharmacy. We aimed to validate the GheOPS-tool as an effective screening method for PIP.
All patients admitted to the acute geriatric ward of the Sint-Vincentius hospital (Belgium) were consecutively screened for inclusion (≥70 years,≥5 drugs chronically). PIP prevalence was evaluated by applying the GheOPS-tool on the complete medication history. For each PIP-item, clinical relevance of the detected item, relevance of proposed alternative and subsequent acceptance by the treating geriatrician and a general practitioner were evaluated. Additionally, contribution to the current admission and preventability was assessed by the geriatrician. The completeness of a PIP-screening with the GheOPS-tool was evaluated through comparison with the adapted Medication Appropriateness Index (aMAI).
We detected 250 GheOPS-items in 57 of 60 included patients (95%) (median: four PIP-items per patient; IQR: 3-5). Both the geriatrician and the general practitioners scored the clinical relevance of the detected items 'serious' or 'significant' in over 70% of cases. Proposed alternative treatment plans were accepted for 79% of the PIP-items (n = 198). The aMAI detected 536 items, of which 145 were also detected by the GheOPS-tool. A total of 119 PIP-items were additionally detected by the GheOPS-tool.
The clinical relevance of the PIP-items detected with the GheOPS-tool is high, likewise the acceptance rate of proposed alternatives.
根特老年人处方社区药房筛查（GheOPS-）工具最近被开发出来，作为一种在社区药房检测潜在不适当处方（PIP）的明确筛查方法。我们旨在验证GheOPS-工具作为一种有效的PIP筛查方法。
连续筛查比利时圣文森特医院急性老年病房收治的所有患者（≥70岁，长期服用≥5种药物），以确定是否纳入研究。通过对完整用药史应用GheOPS-工具来评估PIP患病率。对于每个PIP项目，评估检测到的项目的临床相关性、提议替代方案的相关性以及治疗老年病医生和全科医生随后的接受情况。此外，老年病医生评估其对当前入院情况的影响和可预防性。通过与改编后的用药适宜性指数（aMAI）进行比较，评估使用GheOPS-工具进行PIP筛查的完整性。
在60例纳入研究的患者中，有57例（95%）检测到250个GheOPS项目（中位数：每位患者4个PIP项目；四分位间距：3-5）。在超过70%的病例中，老年病医生和全科医生都将检测到的项目的临床相关性评为“严重”或“显著”。79%的PIP项目（n = 198）的提议替代治疗方案被接受。aMAI检测到536个项目，其中145个也被GheOPS-工具检测到。GheOPS-工具还额外检测到119个PIP项目。
使用GheOPS-工具检测到的PIP项目的临床相关性很高，提议替代方案的接受率同样很高。
