Potentially inappropriate prescribing in elderly patient: analyze before/after hospitalization

Geriatr Psychol Neuropsychiatr Vieil. 2018 Jun 1;16(2):155-163. doi: 10.1684/pnv.2018.0726.

Abstract

In the context of improved medication management in the elderly patient, we were interested in the reevaluation of drug prescription during hospitalization. The aim of this study is to assess the prevalence of inappropriate prescribing in the elderly patient before and after hospitalization.

Patients and methods: This is a descriptive and retrospective study of drug prescriptions in a non-geriatric unit. Prescriptions were analyzed using STOPP/START tool.

Results: Seventy-two patients over 65 years-old were included. A polymedication of 5 or more drugs was reported in 76% of cases (n = 55) at entry and in 90% (n = 65) at discharge. Inappropriate prescribing rate with at least one STOPP criteria decreases from 58% to 29% after hospitalization (p<0.0005). Potential prescribing omissions rate decreases from 46% to 42% after hospitalization (p <0.5465). Drugs most frequently involved were benzodiazepines (21%), antiplatelet agents (11%) and opiates (8%). There was improvement rather qualitative than quantitative of prescribing after hospitalization.

Conclusion: Collaboration between different health professionals seems essential to ensure optimal medication management. This pharmaceutical follow-up approach should make it possible to undertake a multidisciplinary collaboration.

Keywords: drug; medication inappropriate; older people.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Communication
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Inappropriate Prescribing / statistics & numerical data*
  • Male
  • Medication Therapy Management
  • Polypharmacy
  • Retrospective Studies