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Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria

Background Potentially inappropriate prescribing is increasingly common in older patients with falls. However, published indicators to assess inappropriate prescribing remains unestablished in many countries. Objective This study determined the burden and profile of potentially inappropriate prescri...

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Main Authors: Rosalind, Chiam, Nor'izzati, Saedon, Khor, Hui Min, Sukanya, A/P Subramaniam, Siti Sakinah, Binti Mohmad Nasir, Noor Fatin Izzati, Binti Abu Hashim, Tan, Maw Pin *
Format: Article
Published: Springer 2022
Subjects:
RC Internal medicine
RM Therapeutics. Pharmacology
RS Pharmacy and materia medica
Online Access:http://eprints.sunway.edu.my/3015/
https://doi.org/10.1007/s11096-021-01329-9
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spelling my.sunway.eprints.30152024-08-06T06:05:00Z http://eprints.sunway.edu.my/3015/ Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria Rosalind, Chiam Nor'izzati, Saedon Khor, Hui Min Sukanya, A/P Subramaniam Siti Sakinah, Binti Mohmad Nasir Noor Fatin Izzati, Binti Abu Hashim Tan, Maw Pin * RC Internal medicine RM Therapeutics. Pharmacology RS Pharmacy and materia medica Background Potentially inappropriate prescribing is increasingly common in older patients with falls. However, published indicators to assess inappropriate prescribing remains unestablished in many countries. Objective This study determined the burden and profile of potentially inappropriate prescribing among patients attending a falls clinic using the STOPP/START criteria and evaluated the factors for falls potentially associated to inappropriate prescribing. Setting University of Malaya Medical Centre Falls Clinic. Method Data of individuals aged ≥ 65 years referred to the falls and syncope clinic were extracted from the falls registry. Potentially inappropriate prescribing was determined with the STOPP/START version 2 criteria. The relationship between potentially inappropriate prescribing with polypharmacy (≥ 5 medications), comorbidities and clinical variables were determined using Pearson's chi-square and potential confounders adjusted for with multivariate regression. Main outcome measure Potentially inappropriate medicines and/or omitted medicines using STOPP/START criteria. Results Data from 421 individuals, aged 77.8 ± 6.7 years and 53.4% women, were included. Potentially inappropriate prescribing was present in 311 (73.9%). Potentially inappropriate medicines use accounted for 84.6% of the 325 prescriptions. 361/659 instances (54.8%) were falls-risk-increasing drugs, with vasodilators (49.3%) being the main potentially inappropriate medicine identified. Of the 177/421 with polypharmacy, 169/177 (95.5%) were exposed to ≥ one potentially inappropriate medicine. 129 instances of potentially omitted medicines were observed in 109 prescriptions (25.9%). Conclusion STOPP/START criteria are useful to identify potentially inappropriate prescribing at the falls and syncope clinic. This finding has important implications for medication review strategies at falls clinic. Future research should determine whether identifying potentially inappropriate prescribing may reduce adverse falls outcomes among patients in this setting. Springer 2022 Article PeerReviewed Rosalind, Chiam and Nor'izzati, Saedon and Khor, Hui Min and Sukanya, A/P Subramaniam and Siti Sakinah, Binti Mohmad Nasir and Noor Fatin Izzati, Binti Abu Hashim and Tan, Maw Pin * (2022) Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria. International Journal of Clinical Pharmacy, 44. pp. 163-171. ISSN 2210-7703 https://doi.org/10.1007/s11096-021-01329-9 10.1007/s11096-021-01329-9
institution Sunway University
building Sunway Campus Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Sunway University
content_source Sunway Institutional Repository
url_provider http://eprints.sunway.edu.my/
topic RC Internal medicine
RM Therapeutics. Pharmacology
RS Pharmacy and materia medica
spellingShingle RC Internal medicine
RM Therapeutics. Pharmacology
RS Pharmacy and materia medica
Rosalind, Chiam
Nor'izzati, Saedon
Khor, Hui Min
Sukanya, A/P Subramaniam
Siti Sakinah, Binti Mohmad Nasir
Noor Fatin Izzati, Binti Abu Hashim
Tan, Maw Pin *
Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria
description Background Potentially inappropriate prescribing is increasingly common in older patients with falls. However, published indicators to assess inappropriate prescribing remains unestablished in many countries. Objective This study determined the burden and profile of potentially inappropriate prescribing among patients attending a falls clinic using the STOPP/START criteria and evaluated the factors for falls potentially associated to inappropriate prescribing. Setting University of Malaya Medical Centre Falls Clinic. Method Data of individuals aged ≥ 65 years referred to the falls and syncope clinic were extracted from the falls registry. Potentially inappropriate prescribing was determined with the STOPP/START version 2 criteria. The relationship between potentially inappropriate prescribing with polypharmacy (≥ 5 medications), comorbidities and clinical variables were determined using Pearson's chi-square and potential confounders adjusted for with multivariate regression. Main outcome measure Potentially inappropriate medicines and/or omitted medicines using STOPP/START criteria. Results Data from 421 individuals, aged 77.8 ± 6.7 years and 53.4% women, were included. Potentially inappropriate prescribing was present in 311 (73.9%). Potentially inappropriate medicines use accounted for 84.6% of the 325 prescriptions. 361/659 instances (54.8%) were falls-risk-increasing drugs, with vasodilators (49.3%) being the main potentially inappropriate medicine identified. Of the 177/421 with polypharmacy, 169/177 (95.5%) were exposed to ≥ one potentially inappropriate medicine. 129 instances of potentially omitted medicines were observed in 109 prescriptions (25.9%). Conclusion STOPP/START criteria are useful to identify potentially inappropriate prescribing at the falls and syncope clinic. This finding has important implications for medication review strategies at falls clinic. Future research should determine whether identifying potentially inappropriate prescribing may reduce adverse falls outcomes among patients in this setting.
format Article
author Rosalind, Chiam
Nor'izzati, Saedon
Khor, Hui Min
Sukanya, A/P Subramaniam
Siti Sakinah, Binti Mohmad Nasir
Noor Fatin Izzati, Binti Abu Hashim
Tan, Maw Pin *
author_facet Rosalind, Chiam
Nor'izzati, Saedon
Khor, Hui Min
Sukanya, A/P Subramaniam
Siti Sakinah, Binti Mohmad Nasir
Noor Fatin Izzati, Binti Abu Hashim
Tan, Maw Pin *
author_sort Rosalind, Chiam
title Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria
title_short Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria
title_full Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria
title_fullStr Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria
title_full_unstemmed Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria
title_sort potentially inappropriate prescribing in a falls clinic using the stopp and start criteria
publisher Springer
publishDate 2022
url http://eprints.sunway.edu.my/3015/
https://doi.org/10.1007/s11096-021-01329-9
_version_ 1806692472946950144
score 13.211869

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