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Application of the STOPP criteria in hospitalised elderly patients to detect and optimise inappropriate psychopharmaceutical prescriptions

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Abstract

Background

Psychotropic drugs are frequently used in the elderly population, but their inappropriate prescription can cause numerous adverse effects and interactions.

Objective

To evaluate the impact of a multidisciplinary intervention to detect and optimise inappropriate prescriptions of psychotropic drugs in patients aged over 75 years in a hospital setting.

Design, setting, subjects and methods

A prospective study which included every patient aged over 75 years admitted to the Consorcio Hospital General in Valencia, Spain, and who had been prescribed psychotropic drugs inappropriately, carried out over 1 year. The intervention was to detect inappropriate prescriptions of psychotropic drugs using the STOPP criteria, treatment optimisation by a team of psychiatrists, readjustment of the electronic prescription register, and communication to the primary care physician. The impact of the intervention was assessed by measuring the persistence of the changes made 3 months after discharge and by quarterly assessment of inappropriate prescriptions.

Results

Of 4571 admissions, 378 inappropriate prescriptions were detected in 346 patients. The drugs most frequently used were long half-life benzodiazepines (70%), which were substituted in 62% of the cases, withdrawn in 32%, and maintained in 6%. At 3 months follow-up, the changes had been maintained by the patients’ primary care physician in 67%. Evaluation of the prescriptions during the subsequent quarters of the year showed a significant decrease in the inappropriate prescriptions, especially benzodiazepines.

Conclusions

Coordinated intervention by pharmacologists and psychiatrists in hospital settings, and communication between these professionals and primary care teams, can reduce psychotropic drugs inappropriately prescribed to the elderly.

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Acknowledgements

This study was funded by the Foundation for Research at the General Hospital of Valencia.

Author information

Authors and Affiliations

  1. Department of Psychiatry, University General Hospital Consortium, Valencia, Spain

    Claudio Garay-Bravo, A. Peña, M. Molina, P. Piles & J. Salazar

  2. Department of Pharmacy, University General Hospital Consortium, Valencia, Spain

    J. Sanfeliu & P. Blasco

  3. CIBERSAM, Valencia, Spain

    J. Salazar

Authors
  1. Claudio Garay-Bravo
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  2. A. Peña
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  3. M. Molina
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  4. J. Sanfeliu
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  5. P. Piles
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  6. P. Blasco
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  7. J. Salazar
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Corresponding author

Correspondence to Claudio Garay-Bravo.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

The study design was approved by the ethics and clinical research committe at the CHGUV. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Garay-Bravo, C., Peña, A., Molina, M. et al. Application of the STOPP criteria in hospitalised elderly patients to detect and optimise inappropriate psychopharmaceutical prescriptions. Eur Geriatr Med 9, 597–602 (2018). https://doi.org/10.1007/s41999-018-0091-x

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  • DOI: https://doi.org/10.1007/s41999-018-0091-x

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