Candeias Catarina, Gama Jorge, Rodrigues Márcio, Falcão Amílcar, Alves Gilberto
CICS-UBI-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal.
UMP-Union of Portuguese Mercies, Lisboa, Portugal.
Front Pharmacol. 2021 Oct 19;12:747523. doi: 10.3389/fphar.2021.747523. eCollection 2021.
Screening Tool of Older People's Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START) criteria have been used to detect potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs). These criteria were applied to geriatric Portuguese patients receiving post-acute and long-term care to assess the prevalence and predictors of PIMs and PPOs. An observational, retrospective, cross-sectional and multicenter study was performed in 161 patients (aged ≥65 years) from eight Units for Integrated Continuous Care. In these studied patients (mean age: 81.6, 64% female, median number of medications: 9) PIMs were detected in 85.1% and PPOs in 81.4% of patients. While PIMs mainly involved the central nervous system and psychotropic drugs (66.5%), PPOs were mostly related to musculoskeletal system (55.3%) and cardiovascular (39.8%) system. A subsequent analysis with logistic regression found the female gender, the hospital provenience, and the number of medications as predictors of PIMs. Predictors of PPOs were the Charlson Comorbidity Index and history of recent fractures. PIMs and PPOs were highly prevalent in the studied patients receiving post-acute and long-term care in Units for Integrated Continuous Care. Therefore, STOPP/START criteria might be an effective tool for improving prescribing quality and clinical outcomes in these frail elderly patients.
老年人处方筛查工具(STOPP)和正确治疗警示筛查工具(START)标准已被用于检测潜在不适当用药(PIMs)和潜在处方遗漏(PPOs)。这些标准应用于接受急性后期和长期护理的葡萄牙老年患者,以评估PIMs和PPOs的患病率及预测因素。对来自8个综合持续护理单元的161名患者(年龄≥65岁)进行了一项观察性、回顾性、横断面多中心研究。在这些研究对象中(平均年龄:81.6岁,64%为女性,药物中位数数量:9种),85.1%的患者检测到PIMs,81.4%的患者检测到PPOs。PIMs主要涉及中枢神经系统和精神药物(66.5%),而PPOs大多与肌肉骨骼系统(55.3%)和心血管系统(39.8%)有关。随后的逻辑回归分析发现,女性、医院来源和药物数量是PIMs的预测因素。PPOs的预测因素是查尔森合并症指数和近期骨折史。在综合持续护理单元接受急性后期和长期护理的研究对象中,PIMs和PPOs非常普遍。因此,STOPP/START标准可能是改善这些体弱老年患者处方质量和临床结局的有效工具。