Evaluation of Polypharmacy Appropriateness in Elderly Patients Using the STOPP/START Criteria 2014 at Supphasithipasong Hospital, Ubon Ratchathani Province
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Abstract
Elderly patients often have numerous comorbidities that associate to advanced age, polypharmacy and receiving Potentially Inappropriate Medications (PIMs). PIMs in the elderly is related with Adverse Drug Events (ADEs), serious drug-drug interaction and may contribute to excessive morbidity and mortality. The Screening Tool of Older Persons' potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment criteria (STOPP/START) 2014 are the assessing tools for the appropriateness of medications in the elderly. The aims of this study were to identify percentage and frequency of PIMs in elderly using the STOPP/START criteria 2014 and to compare the percentage and frequency of PIMs between two elderly age groups (age 65-74 versus age 75 and over). Methods: The retrospective study was conducted by collecting data using the outpatient prescription database between 1st January and 31st March 2017. Results: A total 410 patients were included in the study. Among them, 212 (51.7%) were female. Mean age of the patients was 74.09±6.76 years (range 65-95 years). Patients had many comorbidities, for example, hypertension (57.1%), dyslipidemia (34.1%) and diabetes (29.0%). The average number of medicines prescribed per patient was 9.23±4.14. According to the criteria, 232 patients (56.6%) contained at least one PIM (STOPP criteria 55.6% (228/410), START criteria 15.1% (49/410). Our study shows that PIMs were found in group age 75 year and older (63%), which higher than the age group of 65-74 year (51.5%). There was statistically significant difference between the two patient groups. The three most common PIMs are as follows; 1) Benzodiazepines and its sedative effect that may cause decreased sensorium and impair balance) (19.7%); 2) Benzodiazepines used every day for more than 4 weeks with no indication for longer treatment (16.1%) and 3) receiving First-generation antihistamines (11.7%), respectively. Conclusion: The highest prevalence of PIMs was found for benzodiazepines and antihistamines drugs. Stakeholders should encourage to promote rational use of these medicines in terms of indication and duration of therapy with the aim to reduce PIMs from these medicines.
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