ASSESSMENT OF THE RATIONALITY OF PRESCRIBING IN ELDERLY INPATIENTS OF A SOUTH INDIAN HOSPITAL USING BEERS 2015 AND STOPP CRITERIA
Author(s)
Nagasubramanian VR1, K P2, NK P2, P P2, R K2, Chandran P2
1Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, TN, India, 2Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
OBJECTIVES: This study assessed the rationality of prescribing in the elderly patients admitted in a tertiary care hospital using BEERS and STOPP criteria. METHODS: This prospective observational study assessed the case records and the medication charts of older adults, aged over 65 years, admitted in the medicine wards for the rationality of the prescriptions using the American Geriatric Society 2015 updated BEERS criteria and the Screening tool of older adults prescriptions (STOPP) by identifying the potentially inappropriate medications (PIMs) in the prescriptions. RESULTS: Prescriptions of 188 elderly patients (116 (62%) males and 72 (38%) females); mean age 68.7 ± 4.7 years) were analyzed. The mean of the drugs prescribed for the study population was found to be 8± 2.4. According to the BEERS criteria, 18.6% of the prescriptions were found to have PIMs, of which chlorpheniramine was found in 8% prescriptions. The other PIMs included Amitriptyline (3%), Levetiracetam, Trihexyphenidyl, Alprazolam, Chlordiazepoxide, Clonazepam, and Diazepam (2% each). According to STOPP, 9.4% of the prescriptions were identified to have PIMs. Diltiazem and Alprazolam were 2% each, Glimepiride, Chlordiazepoxide, Clonazepam, Losartan, Aspirin, Clobazam and Warfarin (1% each). The potentially inappropriate drugs common to BEERS and STOPP were Alprazolam, Chlordiazepoxide and Clonazepam identified in 2% of the prescriptions. The PIMs were not clinically significant requiring discontinuation of the inappropriate medicine, and there were no inappropriate medication-related adverse reactions observed in the participants. CONCLUSIONS: The present study identified 18% of PIMs using Beers and 9.6% of PIMs using STOPPs criteria. More than 80% to 90% of the prescriptions were found to be rational as the above criterion. The study suggests that the application of such screening tools to prescribing decisions may reduce unnecessary medication-related adverse events, hospital admissions and the cost in geriatric prescribing. Though these screening tools are desirable they should only enhance, not replace the clinical judgment.
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PIH75
Topic
Clinical Outcomes, Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Clinical Outcomes Assessment, Pharmacist Interventions and Practices, Safety & Pharmacoepidemiology
Disease
Geriatrics, Multiple Diseases