Potentially inappropriate prescribing among older residents in a geriatric hospital in Israel

Abstract

Background STOPP/START (“screening tool of older persons potentially inappropriate prescriptions”/“screening tool to alert doctors to right treatment”) criteria were formulated to identify potentially inappropriate prescriptions (PIP) and potential prescription omissions (PPO) in older people. Objective To determine the prevalence of PIP and PPO using STOPP/START criteria and to identify associated risk factors. Method Data were prospectively collected from 382 residents’ records in an Israeli geriatric hospital. The study population included subjects ≥65 years of age who were taking at least one medication. Data on demographics, medical histories, current diagnoses, current medications and biochemistry results were collected and analyzed. STOPP/START criteria were applied to each medical file. Results A total of 359 residents comprised the study group (mean age [±SD] 82.7 ± 8.7, 66.6 % females). STOPP identified 430 instances of PIP in 243 (67.7 %) residents, and START identified 151 PPO in 122 (34 %) residents. The number of medications (OR: 1.2, 95 % CI 1.11–1.3), falls (OR: 1.16, 95 % CI 1.021–1.32) and hospitalizations (OR: 1.25, 95 % CI 1.025–1.53) were identified as predictors for STOPP-defined PIP. The Charlson Comorbidity Index (OR: 1.4, 95 % CI 1.17–1.7) was associated with START-defined PPO. Conclusion A high prevalence of PIP/PPO was found among geriatric patients and was associated with number of medications, falls, hospitalizations and Charlson Comorbidity Index score.