Evaluating the prevalence of potentially inappropriate prescribing in older adults in intermediate care facilities: a cross-sectional observational studyReportar como inadecuado




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International Journal of Clinical Pharmacy

, Volume 39, Issue 3, pp 527–535

First Online: 17 March 2017Received: 07 October 2016Accepted: 06 March 2017DOI: 10.1007-s11096-017-0452-4

Cite this article as: Millar, A., Hughes, C. & Ryan, C. Int J Clin Pharm 2017 39: 527. doi:10.1007-s11096-017-0452-4

Abstract

Background Potentially inappropriate prescribing PIP encompassing potentially inappropriate medicines PIMs and potential prescribing omissions PPOs, is prevalent amongst older adults in primary and secondary care. However, PIP prevalence in intermediate care IC is unknown. Objective To determine the prevalence of PIMs-PPOs and associated patient factors. Setting Three IC facilities in Northern Ireland. Method The Screening Tool of Older People’s Prescriptions and the Screening Tool to Alert doctors to Right Treatment were used to identify PIP over 8 weeks. Wilcoxon signed-rank tests were performed to compare the prevalence of PIMs-PPOs at admission and discharge. Spearman’s correlation coefficients were calculated to determine factors associated with PIMs-PPOs p < 0.05 considered significant. Main outcome measure Prevalence of PIMs-PPOs. Results 74 patients mean age 83.5±7.4 years were included. Discharge medication data were available for 30 40.5% patients. 53 71.6% and 22 73.3% patients had ≥1 PIM at admission and discharge, respectively. 45 60.8% and 15 50.0% patients had ≥1 PPO at admission and discharge, respectively. No significant difference was found in PIM-PPO prevalence at admission compared to discharge Z = −0.36, p = 0.72; Z = −1.63, p = 0.10. Increasing comorbidity and medication regimen complexity were associated with PIMs at admission r = 0.265, p = 0.023; r = 0.338 p = 0.003. The number of medicines was correlated with PIMs at admission r = 0.391, p = 0.001 and discharge r = 0.515, p = 0.004. Conclusion Whilst IC represents an ideal setting in which to review prescribing, this study found PIP to be highly prevalent in older adults in IC, with no detectably significant change in prevalence between admission to and discharge from this setting.

KeywordsAged Inappropriate prescribing Intermediate care facilities Northern Ireland Potentially inappropriate medication list 



Autor: Anna Millar - Carmel Hughes - Cristín Ryan

Fuente: https://link.springer.com/







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