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Potentially inappropriate medications in a sample of Portuguese nursing home residents: Does the choice of screening tools matter?

2016-10Journal article Restricted access
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dc.contributor.authorCosta, Filipa Alves da
dc.contributor.authorPeriquito, Catarina
dc.contributor.authorCarneiro, Maria Clara
dc.contributor.authorOliveira, Pedro
dc.contributor.authorFernandes, Ana Isabel
dc.contributor.authorCavaco-Silva, Patrícia
dc.date.accessioned2016-12-20T17:06:02Z
dc.date.available2016-12-20T17:06:02Z
dc.date.issued2016-10
dc.description.abstract"Background: Potentially inappropriate medications (PIMs) are often found in high proportion among the elderly population. The STOPP criteria have been suggested to detect more PIMs in European elderly than the Beers criteria. Objective: This study aimed to determine the prevalence of PIMs and potential prescribing omissions (PPOs) in a sample of Portuguese nursing homes residents. Setting: Four elderly facilities in mainland Portugal Method: A descriptive cross-sectional study was used. Elderly polypharmacy patients were included in the study and their medication (registered in patient clinical records) analysed using the Beers (2012 original version and 2008 version adapted to Portugal), STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria. Data were analysed using univariate and bivariate descriptive statistics, considering a confidence interval of 95 %. Main outcomeE measures: Prevalence of PIMs and PPOs. Results: The sample included 161 individuals, with a mean age of 84.7 years (SD = 6.35), 68.9 % being female. A total of 807 PIMs and 90 PPOs were identified through the application of the three set of criteria. The prevalence of PIMs using the most recent version of the Beers criteria was 85.1 and 42.1 % for independent and dependent of diagnosis, respectively. The Portuguese adaptation of this same tool indicated a lower prevalence of PIMs, 60.3 and 16.7 %, respectively. The prevalence of PIMs using the STOPP criteria was 75.4 %, whilst the prevalence of PPOs, using START, was 42.9 %. There were significant differences in the mean number of PIMs detected depending on the tool used. (p < 0.001). Conclusions The application of the studied criteria in an elderly sample enabled the identification of a notable amount of PIMs and PPOs, indicating there is room for improving the quality of care. The variation in prevalence indicates careful choice of the tool is a prerequisite for engaging in medication review. Using START/STOPP criteria enabled a more holistic approach to the quality of prescribing in the elderly, highlighting low levels of cardiovascular risk prevention and abuse of psychotropic drugs, aside with system failures largely preventable by electronic prescribing and alert generation."pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationda Costa, F.A., Periquito, C., Carneiro, M.C. et al. Int J Clin Pharm (2016) 38: 1103. doi:10.1007/s11096-016-0337-ypt_PT
dc.identifier.doi10.1007/s11096-016-0337-ypt_PT
dc.identifier.issn2210-7703
dc.identifier.urihttp://hdl.handle.net/10400.26/16974
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.relation.publisherversionhttp://link.springer.com/article/10.1007%2Fs11096-016-0337-ypt_PT
dc.subjectBeers criteriapt_PT
dc.subjectInappropriate prescriptionspt_PT
dc.subjectElderlypt_PT
dc.subjectPolypharmacypt_PT
dc.subjectPharmaceutical carept_PT
dc.subjectNursing homespt_PT
dc.subjectSTOPP criteriapt_PT
dc.subjectSTART criteriapt_PT
dc.subjectPrescribing omissionspt_PT
dc.subjectMedication reviewpt_PT
dc.titlePotentially inappropriate medications in a sample of Portuguese nursing home residents: Does the choice of screening tools matter?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1111pt_PT
oaire.citation.startPage1103pt_PT
oaire.citation.titleInternational Journal of Clinical Pharmacypt_PT
oaire.citation.volume38(5)pt_PT
rcaap.embargofctPolítica de copyright da revistapt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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