ORIGINAL ARTICLE

Study of Non-Appropriate Medications Among Elderly Patients in Hospitals Affiliated with IUMS Using The STOPP Screening Tool in 2013

Zahra Kavosi, Leila Vali, Laleh Mahmoudi, Mahya Mirzaie

Zahra Kavosi
Shiraz University of Medical Sciences, Shiraz, Iran.

Leila Vali
Shiraz University of Medical Sciences, Shiraz, Iran.

Laleh Mahmoudi
Shiraz University of Medical Sciences, Shiraz, Iran.

Mahya Mirzaie
Master HealthCare Management, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.. Email: mahyamirzaie@gmail.com
Online First: August 16, 2016 | Cite this Article
Kavosi, Z., Vali, L., Mahmoudi, L., Mirzaie, M. 2016. Study of Non-Appropriate Medications Among Elderly Patients in Hospitals Affiliated with IUMS Using The STOPP Screening Tool in 2013. Bali Medical Journal 5(1): 98-104. DOI:10.15562/bmj.v5i1.276


Background: The use of inappropriate medications in the elderly is an important issue in the health care system. This issue can increase the side effects and the costs. This study aimed to investigate the prescribing of inappropriate medications in elderly patients. Materials & Methods: In this cross- sectional study, 400 elderly people were selected by simple random sampling at four teaching and non- teaching in hospitals affiliated with IUMS during six months of the 2013 year. The data was collected from the profiles of hospitalization of patients and check lists of STOPP criteria and was analyzed using the chi- square test, Mann- Whitney, Spearman correlation coefficients and Kolmogorov- Smirnov. Results: The mean age of the elderly was 73.4 year. The total number of prescribed drugs for studied patients was 4744 of which at least 124(31.1 Percent) inappropriate medication was prescribed for a patient. According to STOPP criteria, most inappropriate prescriptions were in the non- teaching hospitals related to drug classes Benzodiazepine (13.1 Percent) and Long-acting metabolites (6.2 Percent) and the teaching hospitals Benzodiazepine (9 Percent) and Anti-diabetic (2.7 Percent).Prescribed inappropriate drugs have had a significant relationship with the type of hospitalization section and the length of patients’ residence in the teaching hospitals while the number of inappropriate drugs prescribed was increased as the number of diseases of the elderly in non- teaching hospitals was increased significantly. Discussion: The rate of prescribing inappropriate medications among nursing was not considered in good standing. It seems that the introduction of screening tools can improve the accuracy of medication administration and physician partners and in addition to improving the quality of prescribing in the elderly it is required to design a comprehensive instruction for the country.

References

Swanson D, Siegel JS, Shryock HS. The methods and materials of demography.1th Ed. Social Science / Demography books. Elsevier Academic Press; 2004 :1(1) :327-31.

Alexander GL, Rantz M, Skubic M, Koopman RJ, Phillips LJ, Guevara RD, et al. Evolution of an early illness warning system to monitor frail elders in independent living. Journal of healthcare engineering. 2011;2(3): 337-64.

Bagheri-Nesami M, Hamzehgardeshi Z. Experiencing the Onset of Aging: a Qualitative Study. Journal of Mazandaran University of Medical Sciences. 2013;23(102): 26-38.

Scott IA, Gray LC, Martin JH, Mitchell CA. Minimizing inappropriate medications in older populations: a 10-step conceptual framework. The American journal of medicine. 2012;125(6): 529-37.

Sharkey JR, Branch LG, Zohoori N, Giuliani C, Busby-Whitehead J, Haines PS. Inadequate nutrient intakes among homebound elderly and their correlation with individual characteristics and health-related factors. The American journal of clinical nutrition. 2002;76(6): 1435-45.

Woo Ek, Han C, Jo SA, Park MK, Kim S, Kim E, et al. Morbidity and related factors among elderly people in South Korea: results from the Ansan Geriatric (AGE) cohort study. BMC Public Health. 2007;7(1): 10.

Tootoonchi P. The prevalence of chronic diseases and some of the characteristics of aging with disability in the elderlys affiliated with Imam Khomeini Relief Foundation And factors affecting it. Tehran University of Medical Sciences. 2004;3(3): 219-25.

Rogers WA, Stronge AJ, Fisk AD. Technology and aging. Reviews of human factors and ergonomics. 2005;1(1): 130-71.Easley C, Schaller J. The experience of being old-old: Life after 85. Geriatric Nursing. 2003;24(5): 273-77.

Gallagher P, Barry P, O'Mahony D. Inappropriate prescribing in the elderly. Journal of clinical pharmacy and therapeutics. 2007;32(2): 113-21.

Blalock SJ, Byrd JE, Hansen RA, Yamanis TJ, McMullin K, DeVellis BM, et al. Factors associated with potentially inappropriate drug utilization in a sample of rural community-dwelling older adults. The American journal of geriatric pharmacotherapy. 2005;3(3):168-79.

Reilly T, Barile D, Reuben S. Role of the pharmacist on a general medicine acute care for the elderly unit. The American journal of geriatric pharmacotherapy. 2012;10(2): 95-100.

Picon-Camacho SM, Marcos-Lopez M, Bron J, Shinn A. An assessment of the use of drug and non-drug interventions in the treatment of Ichthyophthirius multifiliis Fouquet, 1876, a protozoan parasite of freshwater fish. Parasitology. 2012;139(2):149-90.

Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? The Lancet. 2007;370(9582):173-84.

Hustey FM. Beers criteria and the ED: an adequate standard for inappropriate prescribing? The American journal of emergency medicine. 2008;26(6): 695-96.

Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: an update. Archives of internal medicine. 1997;157(14): 1531-36.

Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Archives of internal medicine. 2003;163(22): 2716-24.

Gillespie U, Alassaad A, Hammarlund-Udenaes M, Mörlin C, Henrohn D, Bertilsson M, et al. Effects of pharmacists' interventions on appropriateness of prescribing and evaluation of the instruments'(MAI, STOPP and STARTs') ability to predict hospitalization–analyses from a randomized controlled trial. PloS one. 2013;8(5): e 62401.

Medicines Management Team. STOPP START Toolkit Supporting Medication Review. NHS Cumbria . 2013; 2-27.

Chen L, Lu J, Zhang N, Huang T, Cai Y-D. A hybrid method for prediction and repositioning of drug Anatomical Therapeutic Chemical classes. Molecular BioSystems. 2014;10(4): 868-77.

Talebi-Taher M, Javad-Moosavi SA, Taherian S, Barati M. Surveying the inappropriate drug adminstrution using Beers criteria in elderly patients at the internal medicine ward of Rasoul-e-Akram Hospital of Tehran in 2012. Arak University of Medical Sciences Journal. 2014;17(2): 33-39.

Vali L," Determine the factors that influence inappropriate medication use in Tehran University of medical sciences affiliated training and non training hospitals". Thesis PhD, School of Public Health, Tehran University of medical sciences, 2011.

Dalleur O, Spinewine A, Henrard S, Losseau C, Speybroeck N, Boland B. Inappropriate prescribing and related hospital admissions in frail older persons according to the STOPP and START criteria. Drugs & aging. 2012;29(10): 829-37.

Yayla ME, Bilge U, Binen E, Keskin A. The Use of START/STOPP criteria for elderly patients in primary care. The Scientific World Journal. 2013;2013.

Nightingale G, Hajjar E, Swartz K, Andrel-Sendecki J, Chapman A. Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer. Journal of Clinical Oncology. 2015; 7550,58.

De Oliveira Alves C, Schuelter-Trevisol F, Trevisol DJ. Beers criteria-based assessment of medication use in hospitalized elderly patients in Southern Brazil. Journal of family medicine and primary care. 2014;3(3):260.

Hedna K. Hakkarainen KM. Gyllensten H. Jönsson NK. Petzold M. Hägg S. Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population-based study. Eur J Clin Pharmacol . 2015;(71)1525–1533.

Hogerzeil H, Ross-Degnan D, Laing R, Ofori-Adjei D, Santoso B, Chowdhury AA, et al. Field tests for rational drug use in twelve developing countries. The Lancet. 1993;342(8884): 1408-10.

Blanco-Reina E, Ariza-Zafra G, Ocaña-Riola R, León-Ortíz M, Bellido-Estévez I. Optimizing elderly pharmacotherapy: polypharmacy vs. undertreatment. Are these two concepts related? European journal of clinical pharmacology. 2015;71(2): 199-207.

Gonzalez ML, Martin MF, De Amezua FOC, Hernández MC, Girones MZ. PS-069 Potentially inappropriate medications in primary care older patients in toledo (SPAIN): the stopp-start criteria compared with the beers criteria. European Journal of Hospital Pharmacy. 2015;22(Suppl 1):A70-A169.

Maldonado C, Vázquez M, Guevara N, Fagiolino P. Use of STOPP/START Criteria to Perform Active Pharmacovigilance in the Elderly. J Pharmacovigilance. 2014;2(146):2.

Vali L, Pour reza A, Foroshani R, Ahmadi B, Kamrani A. Analysis of inappropriate medication use in older adults discharged from hospitals affiliated with Tehran University of Medical Sciences (TUMS) using the Beers criteria in 2010. Iranian Journal of Ageing. 2011;6(21): 56-65.

Karandikar Y, Chaudhari S, Dalal N, Sharma M, Pandit V. Inappropriate prescribing in the elderly: A comparison of two validated screening tools. Journal of Clinical Gerontology and Geriatrics. 2013;4(4): 109-14.

Naugler CT, Brymer C, Stolee P, Arcese Z. Development and validation of an improving prescribing in the elderly tool. The Canadian journal of clinical pharmacology : Journal canadien de pharmacologie clinique. 1999;7(2): 103-107.

Ilić D, Bukumirić Z, Janković S. Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents. Srpski arhiv za celokupno lekarstvo. 2015;143(4-3):174 -79.

Zargarzadeh AH, Mirmoghtadaei P, Sadeghi K. Prescribing of Potentially Inappropriate Medications to Elderly People by Medical Specialists in Isfahan, Iran. Iranian Journal of Pharmaceutical Sciences. 2008;4(4):241-6.

Filomena PJ, García AM, Redondo AF, Fernández S-MM. [Inappropriate prescribing in polymedicated patients over 64 years-old in primary care.]. Atencion primaria/Sociedad Espanola de Medicina de Familia y Comunitaria. 2014

Dalleur O, Deliens C, Losseau C, Spinewire A, Boland B. Inappropriate Prescriptions according to STOPP and related hospital admission in geriatric patients. Int J Clin Pharm. 2011;33(4):707.

Fick DM, Mion LC, Beers MH, L Waller J. Health outcomes associated with potentially inappropriate medication use in older adults. Research in nursing & health. 2008;31(1): 42-51.


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