Background: Elderly patients suffer from chronic diseases and are prone to polypharmacy and potentially inappropriate prescribing (PIP). This study aimed to identify potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients in a tertiary care hospital setting and to estimate the prevalence of polypharmacy.
Methods: This multicenter retrospective observational study reviewed patient data from two major Palestinian hospitals. The collected data included patient demographics, comorbidities, and medications administered during hospitalization and discharge. The study included 247 patients aged ≥ 65 years hospitalized between January 2019 and December 2019. The STOPP/START criteria version 2 was used to identify the prevalence of PIMs and PPOs. Clinical pharmacists verified the data, and SPSS was used for data analysis. Descriptive statistics, one-tailed bivariate correlations, and Pearson’s test were applied to the variables of interest to examine their association with the STOPP/START criteria.
Results: A total of 247 patients were included in the study, and 50.2% were females. As a result, 165 (66.8%) participants were identified with PIPs, including 30 patients with PPOs, 91 with PIMs, and 44 with both. Furthermore, the prevalence of PIP during hospitalization and discharge was 56.29% and 64.39%, respectively. Polypharmacy (5– 9 medications) was 44.5% and 52.1% during hospitalization and discharge, respectively, and excessive polypharmacy (ten medications or more) was 33.6% and 16.4% during hospitalization and discharge, respectively. Moreover, 47.3% of the patients had a comorbidity index of ≥ 5.
Conclusion: This study identified a high prevalence of PIPs among elderly patients during hospital admission and discharge. In addition, more than half of the geriatric patients in this study had PIP and a high prevalence of polypharmacy. Therefore, this study emphasizes the importance of adapting evidence-based tools, such as the STOPP/START criteria, to optimize patient medication therapy and guide prescribers in identifying and resolving PIMs and PPOs.



中文翻译：

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使用 STOPP/START 标准评估巴勒斯坦老年患者的不适当药物处方

背景：老年患者患有慢性疾病，容易出现多种药物和潜在的不适当处方（PIP）。本研究旨在确定三级护理医院环境中老年患者潜在的不适当药物 (PIM) 和潜在的处方遗漏 (PPO)，并估计多种药物的患病率。
方法：这项多中心回顾性观察研究回顾了来自巴勒斯坦两家主要医院的患者数据。收集的数据包括患者人口统计数据、合并症以及住院和出院期间使用的药物。该研究包括 2019 年 1 月至 2019 年 12 月期间住院的 247 名年龄≥65 岁的患者。STOPP/START 标准第 2 版用于确定 PIM 和 PPO 的患病率。临床药师对数据进行验证，采用SPSS进行数据分析。描述性统计、单尾双变量相关性和 Pearson 检验应用于感兴趣的变量，以检查它们与 STOPP/START 标准的关联。
结果：该研究共纳入 247 名患者，其中 50.2% 为女性。结果，165 名 (66.8%) 参与者被确定为 PIP，其中 30 名 PPO 患者，91 名 PIM 患者，44 名两者兼有。此外，住院和出院期间PIP的患病率分别为56.29%和64.39%。住院和出院期间多次用药（5-9 种药物）分别为 44.5% 和 52.1%，住院和出院期间过度多次用药（十种或更多）分别为 33.6% 和 16.4%。此外，47.3%的患者合并症指数≥5。
结论：这项研究确定了在住院和出院期间老年患者​​中 PIP 的高患病率。此外，本研究中超过一半的老年患者患有 PIP 和多种药物的高患病率。因此，本研究强调了采用循证工具（例如 STOPP/START 标准）以优化患者药物治疗并指导开处方者识别和解决 PIM 和 PPO 的重要性。