Advertisement

International Journal of Clinical Pharmacy

, Volume 38, Issue 5, pp 1063–1068 | Cite as

Potentially inappropriate prescribing in nursing home residents detected with the community pharmacist specific GheOP3S-tool

  • Eline TommeleinEmail author
  • Els Mehuys
  • Mirko Petrovic
  • Annemie Somers
  • Charlotte Van Damme
  • Eva Pattyn
  • Kristof Mattelin
  • Koen Boussery
Short Research Report

Abstract

Background The Ghent Older People’s Prescriptions community Pharmacy Screening (GheOP³S-)tool was recently developed to screen for potentially inappropriate prescribing (PIP). Objective We aimed (1) to determine PIP prevalence in older nursing home (NH) residents with polypharmacy using the GheOP³S-tool and (2) to identify those PIPs that are most frequently detected. Method A cross-sectional study was carried out between February and June 2014 in 10 NHs in Belgium, supplied by a community pharmacy chain. For each NH, 40 residents (≥70 years, using ≥5 chronic drugs) were included. PIP prevalence was determined using the GheOP³S-tool. Results 400 NH residents were included [mean age (±SD) 86.2 (±6.3) years; median number of drugs (±IQR) 10 (7–12)]. A total of 1728 PIPs were detected in 387 (97 %) participants (Median 4; IQR 2–6). The most prevalent items can be assigned to three categories: long-term use of central nervous system drugs (i.e. benzodiazepines, antidepressants and antipsychotics), use of anticholinergic drugs (mutual combinations and with underlying constipation/dementia) and underuse of osteoporosis prophylaxis. Conclusion Screening for PIP by means of the GheOP³S-tool revealed a high prevalence of PIP among older NH residents with polypharmacy. This finding urges for initiatives on the patient-level, but also on a broader, institutional level.

Keywords

Aged Belgium GheOP³S Inappropriate prescribing Nursing homes PIP 

Notes

Acknowledgments

We would like to thank the community pharmacy chain for providing us with the dataset and assistance when case clarification was needed.

Funding

No financial remuneration was received for the study.

Conflicts of interest

All authors completed the ICMJE-form. No competing interests were declared.

Supplementary material

11096_2016_366_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 21 kb)

References

  1. 1.
    Loganathan M, Singh S, Franklin BD, Bottle A, Majeed A. Interventions to optimise prescribing in care homes: systematic review. Age Ageing. 2011;40(2):150–62.CrossRefPubMedGoogle Scholar
  2. 2.
    Haasum Y, Fastbom J, Johnell K. Institutionalization as a risk factor for inappropriate drug use in the elderly: a Swedish nationwide register-based study. Ann Pharmacother. 2012;46(3):339–46.CrossRefPubMedGoogle Scholar
  3. 3.
    O’Sullivan DP, O’Mahony D, Parsons C, Hughes C, Murphy K, Patterson S, et al. A prevalence study of potentially inappropriate prescribing in Irish long-term care residents. Drugs Aging. 2013;30(1):39–49.CrossRefPubMedGoogle Scholar
  4. 4.
    Perri M 3rd, Menon AM, Deshpande AD, Shinde SB, Jiang R, Cooper JW, et al. Adverse outcomes associated with inappropriate drug use in nursing homes. Ann Pharmacother. 2005;39(3):405–11.CrossRefPubMedGoogle Scholar
  5. 5.
    Verrue C, Mehuys E, Boussery K, Adriaens E, Remon JP, Petrovic M. A pharmacist-conducted medication review in nursing home residents: impact on the appropriateness of prescribing. Acta Clin Belg. 2012;67(6):423–9.PubMedGoogle Scholar
  6. 6.
    Verrue CL, Petrovic M, Mehuys E, Remon JP, Vander Stichele R. Pharmacists’ interventions for optimization of medication use in nursing homes: a systematic review. Drugs Aging. 2009;26(1):37–49.CrossRefPubMedGoogle Scholar
  7. 7.
    Wallerstedt SM, Kindblom JM, Nylen K, Samuelsson O, Strandell A. Medication reviews for nursing home residents to reduce mortality and hospitalization: systematic review and meta-analysis. Br J Clin Pharmacol. 2014;78(3):488–97.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Mestres C, Agusti A, Puerta L, Barba M. Prescription of potentially inappropriate drugs for geriatric patients in long-term care: improvement through pharmacist’s intervention. Eur J Hosp Pharm Sci Pract. 2015;22(4):198–201.CrossRefGoogle Scholar
  9. 9.
    Tommelein E, Petrovic M, Somers A, Mehuys E, van der Cammen T, Boussery K. Older patients’ prescriptions screening in the community pharmacy: development of the Ghent Older People’s Prescriptions community Pharmacy Screening (GheOP(3)S) tool. J Public Health. 2016;38(2):e158–70. doi: 10.1093/pubmed/fdv090.CrossRefGoogle Scholar
  10. 10.
    Tommelein EM, Van Tongelen I, Petrovic M, Somers A, Colin P, Demarche S, Van Hees T, Christiaens T, Boussery K. Community pharmacists’ evaluation of potentially inappropriate prescribing in older community-dwelling patients with polypharmacy: observational research based on the GheOP3S-tool. (2016, submitted).Google Scholar
  11. 11.
    Belgian Center for Pharmacotherapeutic Information B. Commented drug repertory 2016 [cited 2016 March 25]. http://www.bcfi.be/.
  12. 12.
    WHO Collaborating Centre for Drug Statistics Methodology—Norwegian Institute of Public Health. ATC/DDD Index 2016 [cited 2016 March 26]. http://www.whocc.no/atc_ddd_index/.
  13. 13.
    von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ (Clin Res ed). 2007;335(7624):806–8.CrossRefGoogle Scholar
  14. 14.
    Elseviers MM, Vander Stichele RR, Van Bortel L. Quality of prescribing in Belgian nursing homes: an electronic assessment of the medication chart. Int J Qual Health Care. 2014;26(1):93–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Bergman Å, Olsson J, Carlsten A, Waern M, Fastbom J. Evaluation of the quality of drug therapy among elderly patients in nursing homes: a computerized pharmacy register analysis. Scand J Prim Health Care. 2007;25(1):9–14.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Shah SM, Carey IM, Harris T, DeWilde S, Cook DG. Quality of prescribing in care homes and the community in England and Wales. Br J Gen Pract. 2012;62(598):e329–36.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Kolzsch M, Kopke K, Fischer T, Hofmann W, Kuhnert R, Bolbrinker J, et al. Prescribing of inappropriate medication in nursing home residents in Germany according to a French consensus list: a cross-sectional cohort study. Pharmacoepidemiol Drug Saf. 2011;20(1):12–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol. 2015;71(12):1415–27.CrossRefPubMedGoogle Scholar
  19. 19.
    Ryan C, O’Mahony D, Kennedy J, Weedle P, Cottrell E, Heffernan M, et al. Potentially inappropriate prescribing in older residents in Irish nursing homes. Age Ageing. 2013;42(1):116–20.CrossRefPubMedGoogle Scholar
  20. 20.
    Bourgeois J, Elseviers MM, Van Bortel L, Petrovic M, Vander Stichele RH. Feasibility of discontinuing chronic benzodiazepine use in nursing home residents: a pilot study. Eur J Clin Pharmacol. 2014;70(10):1251–60.CrossRefPubMedGoogle Scholar
  21. 21.
    Kersten H, Molden E, Tolo IK, Skovlund E, Engedal K, Wyller TB. Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: a randomized controlled trial. J Gerontol Ser A Biol Sci Med Sci. 2013;68(3):271–8.CrossRefGoogle Scholar
  22. 22.
    World Health Organization Collaborating Centre for Metabolic Bone Diseases. Fracture risk assessment tool United Kingdom: University of Sheffield [cited 2016 March 25]. https://www.shef.ac.uk/FRAX/tool.jsp.

Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Eline Tommelein
    • 1
    Email author
  • Els Mehuys
    • 1
  • Mirko Petrovic
    • 2
  • Annemie Somers
    • 3
  • Charlotte Van Damme
    • 1
  • Eva Pattyn
    • 1
  • Kristof Mattelin
    • 1
  • Koen Boussery
    • 1
  1. 1.Pharmaceutical Care Unit, Faculty of Pharmaceutical SciencesGhent UniversityGhentBelgium
  2. 2.Department of Internal Medicine, Faculty of Medicine and Health SciencesGhentBelgium
  3. 3.Department of PharmacyGhent University HospitalGhentBelgium

Personalised recommendations