Candeias Catarina, Gama Jorge, Rodrigues Márcio, Meirinho Sara, Falcão Amílcar, Castelo-Branco Miguel, Alves Gilberto
RISE-Health, Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506 Covilhã, Portugal.
ULSCB-Castelo Branco Local Health Unit, Av. Pedro Álvares Cabral, 6000-084 Castelo Branco, Portugal.
J Clin Med. 2025 Apr 22;14(9):2861. doi: 10.3390/jcm14092861.
: Potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) have been widely explored, but few studies focused on patients aged 75 years and over. This study was planned to explore the demographic and clinical characteristics of the older patients admitted to Units for Integrated Continuous Care, and to assess the prevalence and potential predictors of PIMs and PPOs. : An observational, retrospective, and multicenter study was performed on 135 patients aged 75 years or older (i.e., 75-84 years and ≥85 years). PIMs and PPOs were investigated by applying the Screening Tool of Older People's Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START) criteria. : The oldest-old patients (≥85 years) were less likely to come from a hospital, had fewer daily medications and a lower number of oral doses, but they presented a higher Charlson Comorbidity Index, were more dependent on activities of daily living, and were less obese than those aged 75-84 years. Results showed a high prevalence of PIMs and PPOs in both age groups. The more common PIMs and PPOs were the same in both age groups. The oldest-old patients who suffered falls were more likely to have a prescription omission of vitamin D supplements. The PIM index was not significantly different between age groups but was higher in the oldest-old group. : Patients with a higher number of prescriptions had a higher risk of PIMs. Regarding PPOs, male gender and fall risk were predictors in the youngest group, while the number of comorbidities was significantly associated with PPOs in the oldest group. This study supports the usefulness of the STOPP/START criteria to identify PIMs and PPOs in these patients, but more research is required to determine the potential adverse outcomes of PIMs and PPOs and their clinical and economic consequences.
潜在不适当用药（PIMs）和潜在处方遗漏（PPOs）已得到广泛研究，但针对75岁及以上患者的研究较少。本研究旨在探讨入住综合持续护理病房的老年患者的人口统计学和临床特征，并评估PIMs和PPOs的患病率及潜在预测因素。
对135名75岁及以上（即75 - 84岁和≥85岁）的患者进行了一项观察性、回顾性多中心研究。通过应用老年人处方筛查工具（STOPP）和正确治疗警报筛查工具（START）标准来调查PIMs和PPOs。
年龄最大的患者（≥85岁）来自医院的可能性较小，每日用药较少且口服剂量数量较少，但他们的Charlson合并症指数较高，日常生活活动依赖性更强，且比75 - 84岁的患者更不肥胖。结果显示两个年龄组中PIMs和PPOs的患病率都很高。两个年龄组中较常见的PIMs和PPOs相同。跌倒的年龄最大的患者更有可能遗漏维生素D补充剂的处方。年龄组之间的PIM指数没有显著差异，但在年龄最大的组中更高。
处方数量较多的患者发生PIMs的风险更高。关于PPOs，在最年轻的组中，男性性别和跌倒风险是预测因素，而在年龄最大的组中，合并症数量与PPOs显著相关。本研究支持使用STOPP/START标准来识别这些患者中的PIMs和PPOs，但需要更多研究来确定PIMs和PPOs的潜在不良后果及其临床和经济影响。
