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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S137
was benzodiazepine (taken for ≥4 weeks; increase the risk of fall)
and use of proton pump inhibitor.
START detected 48 potential prescribing omissions in 44 patients.
Calcium-vitamin D supplementation in osteoporosis was the
most frequent (40%). Omissions corresponding to vaccines
(Pneumococcal vaccine) and the cardiovascular system involving
25% and 30% of patients respectively.
Conclusion:
The STOPP-START criteria reveal that pre-admission
PIM use is highly prevalent among elderly patients, the most
frequently was benzodiazepine. The prescribing omissions detected
by the START criteria require intervention.
P-392
STOPP/START criteria version 2 and 2012 Beers’ criteria:
Are they complementary?
E.H. Azana Fernandez
1
, Y.R. Davila Barboza
1
1
Hospital San Juan de Dios, Le´on, Spain
Introduction:
Some important essential differences between
STOPP/START and Beers criteria remain, principally the list of START
criteria and the avoidance of mention of some Beers criteria drugs
that are now absent from most European drug formularies
Objectives:
Assess the prevalence of potentially inappropriate
medication use in older people.
Method:
We retrospectively studied patients hospitalised at
Geriatric Department during October to November 2014. Diagnoses
and pre-admission medication were recorded.
Results:
100 patients were included, mean patient age was
85.26
±
5.4 years. 72% were female. Mean Charlson’s index: 1.97.
Mean number of prescription medicines: 7.9. Polypharmacy
(≥5 drugs): 76%. Excessive polypharmacy (≥10 drugs): 38%.
Potentially inappropriate medications (PIMs): STOPP identified 94
PIMs affecting 70 patients, the most frequently encountered PIM
was benzodiazepine (taken for ≥4 weeks; increase the risk of fall)
and use of proton pump inhibitor. Beer’s criteria identified 51 PIMs
affecting 36 patients, the most frequently encountered PIM was
short-intermediate acting benzodiazepine.
The correlation between both criteria was weak, with a Kappa
index of 0.22.
Conclusion:
Pre-admissi ´on PIM use is highly prevalent among
elderly patients, the most frequently was benzodiazepine. Because
the majority of criteria PIMs do not overlap in Beers and STOPP,
both list could be complementary.
P-393
Quality of pharmacotherapy in old age: focus on lists of
Potentially Inappropriate Medication (PIM lists). Results from
the European Science Foundation exploratory workshop
M. Azermai
1
, R. Vander Stichele
2
, M. Elseviers
2
1
Ghent University, Gent, Belgium;
2
Ghent University, Heymans
Institute of Pharmacology, Division of Clinical Pharmacology, Gent,
Belgium
Objectives:
On June 12–14, 2014, experts gathered in Ghent,
Belgium, for a European Science Foundation workshop on
pharmacotherapy in old age, aiming to define the requirements
for electronic assessment of Potentially Inappropriate Medication
(PIM) lists.
Methods:
15 experts from 8 European countries. The program
consisted of 5 sessions: conceptual framework; repository of
PIMs out of existing lists of PIMs; identification of PIMs suitable
for electronic assessment based on routinely collected data;
relationship with quality indicators; international collaboration.
Draft recommendations were proposed based on the panel
discussions, which were again discussed by the experts to achieve
consensus for the final recommendations.
Results:
The experts agreed that a repository should be
maintained of all existing PIMs, which are part of at least one
existing list, and which have undergone efforts of validation of
their contents. PIMs suitable for electronic, broad, and regular
evaluation of pharmacotherapy should be identified, with the
distinction between drug-oriented and more clinically oriented
PIMs. Prerequisites for electronic assessment involve precise
codification of medication, clinical data and the decision rules to
permit secondary use of routinely collected clinical data in specific
settings and on national as well as international level. Throughout
the development of PIMs, researchers should consider their
suitability for electronic application and semantic interoperability.
Conclusion:
PIM lists are mainly used in research settings or in
preparation of medication chart reviews. The requirements for
automated electronic use of PIMsin routine auditing of the quality
of pharmacotherapy in old age are yet to be fulfilled in most
countries.
P-394
Potentially inappropiate use of drugs in patients attending
a geriatric day hospital
E. Baeza-Monedero
1
, E. De Jaime
2
, P. Fern ´andez-Montalb ´an
1
,
C. S ´anchez Castellano
1
, A.J. Cruz-Jentoft
3
, R. Miralles
2
1
Hospital Ram´on y Cajal, Madrid, Spain;
2
Parc de Salut Mar
–
Centre
Forum, Barcelona, Spain;
3
Hospital Universitario Ram´on y Cajal,
Madrid, Spain
Objectives:
To describe potentially inappropriate prescriptions
before and after an intervention in a Geriatric Day Hospital (GDH).
Material and Methods:
We reviewed retrospectively the clinical
records of all patients discharged from a Geriatric Day Hospital in
one year. Drug treatment was assessed at the times of admission
and discharge, using 2014 STOPP-START criteria.
Results:
139 subjects included, mean age 80. On admission,
97 (69.8%) met at least one STOPP criteria. The most common
criteria were: use of full-dose PPIs for more than 8 weeks
(49.6%), use of drugs that increase the risk of falls (24.8%),
benzodiazepines for more than 4 weeks (24.1%) and use of long-
term NSAIDs for the symptomatic treatment of osteoarthritis (5.6%).
At admission, 40 patients met at least one START criteria (28.8%);
the most prevalent were: lack of antiresorptive treatment or bone
anabolic steroids in patients with known osteoporosis (8.5%), lack
of calcium supplements and vitamin D (5.6%) and non-use of
acetylcholinesterase inhibitors for mild to moderate Alzheimer’s
disease or dementia with Lewy bodies (4.2%).
At GDH discharge, the most frequent STOPP criteria was still the use
of PPIs without a clear indication (42.5%) and the most frequent
START criteria was not using antiresorptive or anabolic bone in
osteoporosis (4.2%).
Conclusion:
The most prevalent inappropriate drug treatment in
patients attending a GDH was the chronic use of PPI for more than
8 weeks, and this was not improved at GDH discharge.
P-395
Inappropiate use of drugs before and after an intervention
in a geriatric day hospital
E. Baeza-Monedero
1
, E. De Jaime
2
, J. Alb ´eniz-L ´opez
3
, B. Montero-
Errasqu´ın
1
, A.J. Cruz-Jentoft
4
, R. Miralles
2
1
Hospital Ram´on y Cajal, Madrid, Spain;
2
Parc de Salut Mar
–
Centre
Forum, Barcelona, Spain;
3
Ram´on y Cajal, Madrid, Spain;
4
Hospital
Universitario Ram´on y Cajal, Madrid, Spain
Objective:
To study the prevalence of inappropriate prescriptions
before and after an intervention in a Geriatric Day Hospital (GDH).
Material and Methods:
We reviewed retrospectively the clinical
records of all patients discharged from a Geriatric Day Hospital in
one year. Drug treatment was assessed at the times of admission
and discharge, using 2014 STOPP-START criteria.
Results:
139 subjects were included, mean age 80. The mean
number of STOPP criteria at admission was 1.93
±
1.09, reduced at