Study of Inappropriate Medication Prescribed to the Elderly Hospitalized Patients Using the START Screening Tool

Abstract

Objectives Aging population is of global concern and care for the health and quality of life for people over 65 years of major issues and problems of today and the future will be . Medication is an essential component of care for elderly patients, and optimizing the treatment for elderly patients is challenging. The aim of this study was to evaluate the state of appropriate non-prescribed drugs in 60 elderly patients hospitalized in teaching and non-teaching hospitals in the University of Medical Sciences by using screening tool START. Methods & Materials This cross-sectional study included 400 randomly selected elderly patients of Parts common (CCU, ENT, ICU General, Orthopedics, Surgery General, The Internal) hospitalized within six months (from June to December 2013). The data from the hospital records of the selected patients were collected to determine the appropriate medications prescribed by the criterion START. The data was analyzed using software Excel 2013 and SPSS 18, and the relationship between variables was determined by using the chi-square test, Mann-Whitney, Spearman correlation coefficient, and Kolmogorov-Smirnov test. Results The average age of the elderly patients was 73.4 years. Cardiovascular disease had the largest prevalence (21.6%) and diabetes (3.0) had the lowest prevalence among the elderly patients. The total number of drugs prescribed for patients was 4744; of which, 158 patients (39.6%) were not prescribed with at least one appropriate medication. The most appropriate medications that were not prescribed according to START were related to bisphosphonates category (11.7% vs. 13.3%) and anti-diabetic category (8.3% vs. 11.4%) in non-training and training hospitals. There was a significant relationship between the average appropriate medication not prescribed and the length of stay of patients in teaching hospitals. The number of appropriate medication not prescribed with the increasing number of prescribed medications has increased significantly. Conclusion Since issues relating to the appropriate medications prescribed among the elderly can be serious, the drugs prescribed for the elderly are very important. Supervising the prescription, supply, and rational use of drugs is very vital and effective and as part of the health budget allocated to the drug. Therefore, hospitals can take advantage of physicians with medical consultants and expert opinions of clinical pharmacists in handling this problem