Multidisciplinary medication review during older patient hospitalization according to STOPP/START criteria reduces potentially inappropriate prescriptions : MoPIM cohort study
Ortonobes, Sara (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Herranz, Susana (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Lleal Custey, Marina (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Sevilla-Sánchez, Daniel (Parc Sanitari Pere Virgili)
Jordana, Rosa (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Mascaró, Oscar (Universitat de Vic - Universitat Central de Catalunya)
Ferrández, Olivia (Parc de Salut MAR de Barcelona)
De Jaime, Elisabet (Parc de Salut MAR de Barcelona)
Estrada, Rafael (Hospital de Galdakao (Usansolo, Biscaia))
Nazco, Gloria Julia (Hospital Universitario de Canarias (La Laguna))
Baré i Mañas, Marisa (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
MoPIM Study Group
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Purpose: Multimorbidity and polypharmacy in older adults converts the detection and adequacy of potentially inappropriate drug prescriptions (PIDP) in a healthcare priority. The objectives of this study are to describe the clinical decisions taken after the identification of PIDP by clinical pharmacists, using STOPP/START criteria, and to evaluate the degree of accomplishment of these decisions. Methods: Multicenter, prospective, non-comparative cohort study in patients aged 65 and older, hospitalized because of an exacerbation of their chronic conditions. Each possible PIDP was manually identified by the clinical pharmacist at admission and an initial decision was taken by a multidisciplinary clinical committee. At discharge, criteria were re-applied and final decisions recorded. Results: From all patients (n = 674), 493 (73. 1%) presented at least one STOPP criteria at admission, significantly reduced up to 258 (38. 3%) at discharge. A similar trend was observed for START criteria (36. 7% vs. 15. 7%). Regarding the top 10 most prevalent STOPP criteria, the clinical committee initially agreed to withdraw 257 (34. 2%) prescriptions and to modify 93 (12. 4%) prescriptions. However, the evaluation of final clinical decisions revealed that 503 (67. 0%) of those STOPP criteria were ultimately amended. For the top 10 START criteria associated PIDP, the committee decided to initiate 149 (51. 7%) prescriptions, while a total of 198 (68. 8%) were finally introduced at discharge. Conclusions: The clinical committee, through a pharmacotherapy review, succeeded in identifying and reducing the degree of prescription inadequacy, for both STOPP and START criteria, in older patients with high degree of multimorbidity and polypharmacy. Trial Registration: NCT02830425.
Grants:	Ministerio de Economía y Competitividad PI15/00552 Ministerio de Economía y Competitividad RD16/0001/0002
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Clinical committee review ; Multimorbidity ; Older adults ; Polypharmacy ; Potentially inappropriate prescription ; Prescription adequacy
Published in:	BMC geriatrics, Vol. 24 Núm. 1 (december 2024) , p. 584, ISSN 1471-2318

DOI: 10.1186/s12877-024-05185-w
PMID: 38978009

14 p, 3.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Parc Taulí Research and Innovation Institute (I3PT
Articles > Research articles
Articles > Published articles