Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria.

Hdl Handle:
http://hdl.handle.net/10147/137050
Title:
Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria.
Authors:
Gallagher, P F; O'Connor, M N; O'Mahony, D
Affiliation:
Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland. pfgallagher77@eircom.net
Citation:
Prevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria. 2011, 89 (6):845-54 Clin. Pharmacol. Ther.
Journal:
Clinical pharmacology and therapeutics
Issue Date:
Jun-2011
URI:
http://hdl.handle.net/10147/137050
DOI:
10.1038/clpt.2011.44
PubMed ID:
21508941
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/21508941
Abstract:
Inappropriate prescribing is particularly common in older patients and is associated with adverse drug events (ADEs), hospitalization, and wasteful utilization of resources. We randomized 400 hospitalized patients aged ≥ 65 years to receive either the usual pharmaceutical care (control) or screening with STOPP/START criteria followed up with recommendations to their attending physicians (intervention). The Medication Appropriateness Index (MAI) and Assessment of Underutilization (AOU) index were used to assess prescribing appropriateness, both at the time of discharge and for 6 months after discharge. Unnecessary polypharmacy, the use of drugs at incorrect doses, and potential drug-drug and drug-disease interactions were significantly lower in the intervention group at discharge (absolute risk reduction 35.7%, number needed to screen to yield improvement in MAI = 2.8 (95% confidence interval 2.2-3.8)). Underutilization of clinically indicated medications was also reduced (absolute risk reduction 21.2%, number needed to screen to yield reduction in AOU = 4.7 (95% confidence interval 3.4-7.5)). Significant improvements in prescribing appropriateness were sustained for 6 months after discharge.
Item Type:
Article
Language:
en
MeSH:
Age Factors; Aged; Aged, 80 and over; Drug Prescriptions; Female; Follow-Up Studies; Hospitalization; Humans; Inappropriate Prescribing; Male; Polypharmacy
ISSN:
1532-6535

Full metadata record

DC FieldValue Language
dc.contributor.authorGallagher, P Fen
dc.contributor.authorO'Connor, M Nen
dc.contributor.authorO'Mahony, Den
dc.date.accessioned2011-07-27T11:01:18Z-
dc.date.available2011-07-27T11:01:18Z-
dc.date.issued2011-06-
dc.identifier.citationPrevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria. 2011, 89 (6):845-54 Clin. Pharmacol. Ther.en
dc.identifier.issn1532-6535-
dc.identifier.pmid21508941-
dc.identifier.doi10.1038/clpt.2011.44-
dc.identifier.urihttp://hdl.handle.net/10147/137050-
dc.description.abstractInappropriate prescribing is particularly common in older patients and is associated with adverse drug events (ADEs), hospitalization, and wasteful utilization of resources. We randomized 400 hospitalized patients aged ≥ 65 years to receive either the usual pharmaceutical care (control) or screening with STOPP/START criteria followed up with recommendations to their attending physicians (intervention). The Medication Appropriateness Index (MAI) and Assessment of Underutilization (AOU) index were used to assess prescribing appropriateness, both at the time of discharge and for 6 months after discharge. Unnecessary polypharmacy, the use of drugs at incorrect doses, and potential drug-drug and drug-disease interactions were significantly lower in the intervention group at discharge (absolute risk reduction 35.7%, number needed to screen to yield improvement in MAI = 2.8 (95% confidence interval 2.2-3.8)). Underutilization of clinically indicated medications was also reduced (absolute risk reduction 21.2%, number needed to screen to yield reduction in AOU = 4.7 (95% confidence interval 3.4-7.5)). Significant improvements in prescribing appropriateness were sustained for 6 months after discharge.-
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/21508941en
dc.subject.meshAge Factors-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshDrug Prescriptions-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshHospitalization-
dc.subject.meshHumans-
dc.subject.meshInappropriate Prescribing-
dc.subject.meshMale-
dc.subject.meshPolypharmacy-
dc.titlePrevention of potentially inappropriate prescribing for elderly patients: a randomized controlled trial using STOPP/START criteria.en
dc.typeArticleen
dc.contributor.departmentDepartment of Geriatric Medicine, Cork University Hospital, Cork, Ireland. pfgallagher77@eircom.neten
dc.identifier.journalClinical pharmacology and therapeuticsen
dc.description.provinceMunster-

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