START (screening tool to alert doctors to the right treatment)--an evidence-based screening tool to detect prescribing omissions in elderly patients.

Hdl Handle:
http://hdl.handle.net/10147/209262
Title:
START (screening tool to alert doctors to the right treatment)--an evidence-based screening tool to detect prescribing omissions in elderly patients.
Authors:
Barry, P J; Gallagher, P; Ryan, C; O'mahony, D
Affiliation:
Cork University Hospital, Department of Geriatric Medicine, Ireland., pat_barry@eircom.net
Citation:
Age Ageing. 2007 Nov;36(6):632-8. Epub 2007 Sep 19.
Journal:
Age and ageing
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209262
DOI:
10.1093/ageing/afm118
PubMed ID:
17881418
Abstract:
BACKGROUND: Inappropriate prescribing encompasses acts of commission i.e. giving drugs that are contraindicated or unsuitable, and acts of omission i.e. failure to prescribe drugs when indicated due to ignorance of evidence base or other irrational basis e.g. ageism. There are considerable published data on the prevalence of inappropriate prescribing; however, there are no recent published data on the prevalence of acts of omission. The aim of this study was to calculate the prevalence of acts of prescribing omission in a population of consecutively hospitalised elderly people. METHODS: A screening tool (screening tool to alert doctors to the right treatment acronym, START), devised from evidence-based prescribing indicators and arranged according to physiological systems was prepared and validated for identifying prescribing omissions in older adults. Data on active medical problems and prescribed medicines were collected in 600 consecutive elderly patients admitted from the community with acute illness to a teaching hospital. On identification of an omitted medication, the patient's medical records were studied to look for a valid reason for the prescribing omission. RESULTS: Using the START list, we found one or more prescribing omissions in 57.9% of patients. In order of prevalence, the most common prescribing omissions were: statins in atherosclerotic disease (26%), warfarin in chronic atrial fibrillation (9.5%), anti-platelet therapy in arterial disease (7.3%) and calcium/vitamin D supplementation in symptomatic osteoporosis (6%). CONCLUSION: Failure to prescribe appropriate medicines is a highly prevalent problem among older people presenting to hospital with acute illness. A validated screening tool (START) is one method of systematically identifying appropriate omitted medicines in clinical practice.
Language:
eng
MeSH:
Age Factors; Aged; Aged, 80 and over; Atherosclerosis/drug therapy; Atrial Fibrillation/drug therapy; Calcium/administration & dosage/economics/therapeutic use; Dietary Supplements; Evidence-Based Medicine/*methods; Guideline Adherence/*statistics & numerical data; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors/economics/therapeutic use; Mass Screening/*methods; Osteoporosis/drug therapy; Physician's Practice Patterns/*statistics & numerical data; Platelet Aggregation Inhibitors/economics/therapeutic use; Prevalence; Vascular Diseases/drug therapy; Warfarin/economics/therapeutic use
ISSN:
1468-2834 (Electronic); 0002-0729 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBarry, P Jen_GB
dc.contributor.authorGallagher, Pen_GB
dc.contributor.authorRyan, Cen_GB
dc.contributor.authorO'mahony, Den_GB
dc.date.accessioned2012-02-03T15:16:33Z-
dc.date.available2012-02-03T15:16:33Z-
dc.date.issued2012-02-03T15:16:33Z-
dc.identifier.citationAge Ageing. 2007 Nov;36(6):632-8. Epub 2007 Sep 19.en_GB
dc.identifier.issn1468-2834 (Electronic)en_GB
dc.identifier.issn0002-0729 (Linking)en_GB
dc.identifier.pmid17881418en_GB
dc.identifier.doi10.1093/ageing/afm118en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209262-
dc.description.abstractBACKGROUND: Inappropriate prescribing encompasses acts of commission i.e. giving drugs that are contraindicated or unsuitable, and acts of omission i.e. failure to prescribe drugs when indicated due to ignorance of evidence base or other irrational basis e.g. ageism. There are considerable published data on the prevalence of inappropriate prescribing; however, there are no recent published data on the prevalence of acts of omission. The aim of this study was to calculate the prevalence of acts of prescribing omission in a population of consecutively hospitalised elderly people. METHODS: A screening tool (screening tool to alert doctors to the right treatment acronym, START), devised from evidence-based prescribing indicators and arranged according to physiological systems was prepared and validated for identifying prescribing omissions in older adults. Data on active medical problems and prescribed medicines were collected in 600 consecutive elderly patients admitted from the community with acute illness to a teaching hospital. On identification of an omitted medication, the patient's medical records were studied to look for a valid reason for the prescribing omission. RESULTS: Using the START list, we found one or more prescribing omissions in 57.9% of patients. In order of prevalence, the most common prescribing omissions were: statins in atherosclerotic disease (26%), warfarin in chronic atrial fibrillation (9.5%), anti-platelet therapy in arterial disease (7.3%) and calcium/vitamin D supplementation in symptomatic osteoporosis (6%). CONCLUSION: Failure to prescribe appropriate medicines is a highly prevalent problem among older people presenting to hospital with acute illness. A validated screening tool (START) is one method of systematically identifying appropriate omitted medicines in clinical practice.en_GB
dc.language.isoengen_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAtherosclerosis/drug therapyen_GB
dc.subject.meshAtrial Fibrillation/drug therapyen_GB
dc.subject.meshCalcium/administration & dosage/economics/therapeutic useen_GB
dc.subject.meshDietary Supplementsen_GB
dc.subject.meshEvidence-Based Medicine/*methodsen_GB
dc.subject.meshGuideline Adherence/*statistics & numerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHydroxymethylglutaryl-CoA Reductase Inhibitors/economics/therapeutic useen_GB
dc.subject.meshMass Screening/*methodsen_GB
dc.subject.meshOsteoporosis/drug therapyen_GB
dc.subject.meshPhysician's Practice Patterns/*statistics & numerical dataen_GB
dc.subject.meshPlatelet Aggregation Inhibitors/economics/therapeutic useen_GB
dc.subject.meshPrevalenceen_GB
dc.subject.meshVascular Diseases/drug therapyen_GB
dc.subject.meshWarfarin/economics/therapeutic useen_GB
dc.titleSTART (screening tool to alert doctors to the right treatment)--an evidence-based screening tool to detect prescribing omissions in elderly patients.en_GB
dc.contributor.departmentCork University Hospital, Department of Geriatric Medicine, Ireland., pat_barry@eircom.neten_GB
dc.identifier.journalAge and ageingen_GB
dc.description.provinceMunster-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.