Potential prescribing omissions according to START criteria at the time of hospital discharge

Authors

  • Aline Cristina Luz Pharmacist, Federal University of Bahia, Salvador, Bahia, Brazil, https://orcid.org/0000-0001-5281-7889
  • Márcio Galvão Oliveira Associate Professor, Multidisciplinary Health Institute, Federal University of Bahia (UFBA), Vitória da Conquista, Bahia, Brazil
  • Lúcia Noblat Associate Professor, School of Pharmacy, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil

DOI:

https://doi.org/10.1590/s2175-979020200004181060

Keywords:

Health Services for the Aged. Aged. Patient Discharge. Geriatrics. Patient Safety

Abstract

The purpose of this study is to describe the frequency of potential drug prescribing omissions (PPOs) for elderly patients at the time of hospital discharge and to compare the frequency PPOs among different medical specialities. This cross-sectional study examined data from elderly patients when they were admitted for >24 h to a northeastern Brazil teaching hospital during June–December 2016. Were included in the study 227 patients, of whom 36.9% had at least one PPO. The highest number of PPOs was identified among those with at least 5 prescribed drugs. In total, 153 PPOs were identified at hospital discharge. In most cases (78.4%), patients were not evaluated by the specialist physician.The most commonly identified PPOs on discharge were: the omission of statin therapy in cases of diabetes mellitus plus one or more cardiovascular-associated factor; calcium and vitamin D supplements in patients with known osteoporosis; and angiotensin converting enzyme inhibitors in cases of chronic heart failure. The results of this study suggest that the frequency of prescribing omissions PPOs during patient discharge was high. This can be avoided by the careful evaluation by prescribers with experience in certain specialties where several prescribed omissions would be common.

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References

Ali MAS, Lobos CM, Abdelmegid MAF, El-Sayed AM. The frequency and nature of medication errors in hospitalized patients with acute coronary syndrome. Int J Clin Pharm. 2017;39(3):542-50.

Barker KN, Flynn EA, Pepper GA, Bates DW, Mikeal RL. Medication errors observed in 36 health care facilities. Arch Intern Med. 2002:162(16);1897-903.

Barry PJ, Gallagher P, Ryan C, O’mahony D. START (screening tool to alert doctors to thevright treatment)—an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing. 2007;36(6):632-8.

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40 (5):373-83.

Dalleur O, Spinewine A, Henrard S, Losseau C, Speybroeck N, Boland B. Inappropriate prescribing and related hospital admissions in frail older persons according to the STOPP and START criteria. Drugs Aging. 2012;29(10):829-37.

Frankenthal D, Lerman Y, Lerman Y. The impact of hospitalization on potentially inappropriate prescribing in an acute medical geriatric division. Int J Clin Pharm. 2015;37(1):60-67.

Luz AC, Oliveira MG, Noblat L. Cross-cultural adaptation and content validation of START. Sao Paulo Med J. 2016;134(1):20-7.

Brasil. Estatuto do Idoso/Ministério da Saúde. In: Ministério da saúde. 2013. http://bvsms.saude.gov.br/bvs/publicacoes/estatuto_idoso_3edicao.pdf . Accessed 09 Jun 2015.

» http://bvsms.saude.gov.br/bvs/publicacoes/estatuto_idoso_3edicao.pdf

Mori AL, Carvalho RC, Aguiar PM, de Lima MG, Rossi MD, Carrillo JF, et al. Potentially inappropriate prescribing and associated factors in elderly patients at hospital discharge in Brazil: a cross-sectional study. Int J Clin Pharm. 2017;39(2):386-93.

Mortazavi SS, Shati, M; Keshtkar, A; Malakouti, SK; Bazargan, M; Assari, S. Defining polypharmacy in the elderly: a systematic review protocol. BMJ Open 2016; 6 (3): e010989.

O’Connor MN, Gallagher P, O’Mahony D, 2012. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging 2012;29(6):437-52

O’Mahony D, Gallagher P, Ryan C, et. al. STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age. In. Vol 1: European Geriatric Medicine; 2010;1(1):45-51.

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Published

2022-11-09

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Section

Original Article

How to Cite

Potential prescribing omissions according to START criteria at the time of hospital discharge. (2022). Brazilian Journal of Pharmaceutical Sciences, 57. https://doi.org/10.1590/s2175-979020200004181060