Detection of potentially inappropriate medications in elderly patients during hospitalization using three different protocols

Abstract

Cilj istraživanja bio je odrediti učestalost propisivanja potencijalno neprikladnih lijekova u bolesnika starije životne dobi tijekom hospitalizacije koristeći Beersove kriterije, STOPP kriterije i sveobuhvatni protokol. U presječno opservacijsko istraživanje provedeno u Kliničkoj bolnici Dubrava bili su uključeni akutno i elektivno hospitalizirani bolesnici u dobi od 65 i više godina koji su uzimali dva ili više lijekova i koji su potpisali pristanak za sudjelovanje u istraživanju. Potencijalno neprikladni lijekovi bili su određeni pomoću tri različita protokola: Beersovih kriterija, STOPP kriterija i sveobuhvatnog hrvatskog protokola. Ukupno je bilo uključeno 100 bolesnika prosječne dobi 73,99 godina (raspon 65-92), koji su u prosjeku trošili 6,84 lijekova (raspon 2-15) te imali 3,82 dijagnoze (raspon 0-11). Pomoću Beersovih kriterija otkriveno je 17,22% PNL-a, pomoću STOPP kriterija 26,49% PNL-a, a sveobuhvatnim protokolom otkriveno je 56,29% PNL-a te se sveobuhvatni protokol pokazao najučinkovitijim u otkrivanju PNL-a. Najčešće propisivani potencijalno neprikladan lijek prema sva tri protokola bio je diazepam. Pomoću tri različita protokola otkriven je visok postotak primjene neprikladnih lijekova, a sveobuhvatni protokol hrvatskih autorica bio je uspješniji u otkrivanju PNL-a. Korištenjem protokola za detekciju PNL-a postiže se racionalnije propisivanje lijekova, poboljšava kvaliteta života i smanjuju ukupni troškovi liječenja.The aim of this study was to determine prevalence of prescribing potentially inappropriate medications (PIMs) in elderly patients during hospitalization. Beers and STOPP criteria and a comprehensive protocol were used to detect potentially inappropriate medications. A cross-sectional observational study was conducted in University Hospital Dubrava. We included acutelly and electively admitted inpatients aged 65 years and older who were taking two or more drugs and who had signed consent to participate in research. PIMs were determined using three different protocols: Beer’s criteria, STOPP criteria and comprehensive Croatian protocols. The study included 100 patients with a median age 73,99 years (range 65-92). On average, the patients spent 6,84 medications (range 2-15) and had a diagnosis of 3,82 (range 0-11). The Beers criteria detected 17,22% of PIMs, the STOPP criteria 26,49% PIMs and the comprehensive protocol 56,29% PIMs. A comprehensive protocol proved to be the best tool in the detection of PIMs. According to all three protocols, the most prevalent inappropriate drug was diazepam. Three different protocols revealed a high percentage of inappropriate application of drugs and a comprehensive protocol proved to be the best tool in the detection of PIMs. Using different protocols in detecting potentially inappropriate medications causes more rational prescribing, improves life quality and reduces the overall cost of treatment