• Int J Clin Pharm · Apr 2016

    Comparative Study Observational Study

    Potentially inappropriate drug prescribing in elderly hospitalized patients: an analysis and comparison of explicit criteria.

    • Concetta Di Giorgio, Alessio Provenzani, and Piera Polidori.
    • ISMETT, Palermo, Italy. digiorgio82@hotmail.it.
    • Int J Clin Pharm. 2016 Apr 1; 38 (2): 462-8.

    BackgroundThe management of therapy in elderly is a critical aspect of primary care. The physio-pathological complexity of the elderly involves the prescription of multiple drugs, exposing them to a higher risk of adverse reactions.ObjectiveAim of this study was to assess the medication use and (potential) inappropriate medications and prescribing omissions in the elderly before and during hospitalization, according to the main tools in literature described, and their relation to the number of comorbidities.SettingThe study was carried out by the Clinical Pharmacists at ISMETT, an Italian Research Institute.MethodsThe prescriptions of elderly, admitted in ISMETT between January and December 2012, were analyzed. The information about clinical profile of elderly and prescriptions was obtained from the electronic medical records. 2012 Beers criteria, Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria, and Improving Prescribing in the Elderly criteria were used to evaluate the appropriateness of prescriptions. The correlation between the number of comorbidities and the different tools was analyzed with the Spearman correlation coefficient. The frequency analysis was done with the Pearson Chi square test.Main Outcome MeasurePercentage of potentially inappropriate medications and prescribing omissions before/during hospitalization in elderly.Results1027 elderly were admitted between January and December 2012. At admission and during hospitalization, according to Beers criteria 24 and 49 % of elderly had at least one potentially inappropriate medication, respectively; according to the Screening Tool of Older Person's Prescriptions criteria 21 and 27 %, respectively; according to the Improving Prescribing in the Elderly criteria 28 and 25 %, respectively; and then, according to Screening Tool to Alert doctors to Right Treatment criteria 28 and 33 % had at least one potentially prescribing omission, respectively. A significant correlation between comorbidities number and potentially inappropriate medications was found.ConclusionThe number of potentially inappropriate medications globally increased during hospitalization. Statistical analysis showed that the comorbidity affects the level of inappropriate prescriptions. Specific tools can guide clinicians toward a more rational use of medicines and minimize probable complications related to multi-treatments.

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