European Geriatric Medicine - Supplement 1 - Volume 6

S138

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

–

S156

the time of discharge to 1.10

0.31 (p

0.001). The mean number of

START criteria at admission was 0.74

1.40, at discharge 1.22

0.44

(p = 0.18). Mean number of drugs used at admission was 7.95

3.32

and at discharge 7.85

3.20 (p = 0.52).

97 subjects had at least one STOPP inappropriate drug at admission;

of these, 36 (37.1%) had no inappropriate drug after discharge

from the HDG. Of the 41 subjects who did not meet any STOPP

criteria on admission, only 4 (9.8%) were discharged on a potentially

inappropriate drug (p

0.01).

40 subjects needed at least on START listed drug on admission in

36 (90%) these drugs were started. Of the 99 subjects who did not

meet any START criteria on admission, 5 (5.1%) met at least one at

discharge (p = 0.28).

Conclusion:

After a non targeted geriatric intervention in a HDG,

appropriateness of drug use improved significantly, specially in

stopping potentially inappropriate drugs.

P-396

Inappropriate use of antiplatelet therapy in older patients

on anticoagulant therapy for atrial fibrillation

S. Marien

, O. Dalleur

, A. Spinewine

, B. Boland

LDRI, UCLouvain, Brussels, Belgium;

Clin univ St-Luc, Pharmacy,

Brussels, Belgium;

Cliniques Univ. St Luc, G´eriatrie; UCL/IRSS,

Brussels, Belgium

Introduction:

Older patients on anticoagulation for atrial

fibrillation are sometimes on antiplatelet therapy (AP) which

significantly increases the risk of major bleeding. Using recent

geriatric guidelines, we studied AP inappropriateness in these

patients.

Methods:

Cross-sectional study in 317 patients (84

5 years) in a

Belgian teaching hospital (2008–2010) with older age (≥75 years),

atrial fibrillation, elevated risk of cardio-embolism (CHADS2≥2),

long-term anticoagulation, and comprehensive geriatric assess-

ment. The annual risk of major bleeding was predicted using the

HEMORR2HAGES score. The main endpoint was the inappropriate

use of AP in the absence of recent coronary artery disease (i.e.

12 months after myocardial ischemia or coronary stenting).

Results:

AP, used in 89 patients, was inappropriate in 77 of them.

These 77 patients with inappropriate AP differed from the 228

patients without AP therapy in male gender (57vs.43%, p = 0.04),

diabetes mellitus (32vs.18%, p = 0.01) and ischemic vascular disease

(62vs.45%, p = 0.01). They did not differ in geriatric syndromes and

functional/cognitive status. Their predicted annual risk of major

bleeding was higher than the risk of the 228 patients without AP

(9.3

2% vs. 7.4

2%, p

0.001). Withdrawing AP in these 77 patients

would reduce their annual bleeding risk to 7.5

3%.

Conclusions:

AP withholding or withdrawing in the absence of a

recent ischemic event or coronary stenting might prevent each year

2% of major bleeding in this older population on anticoagulation.

Geriatricians, cardiologists and diabetologists should aim at a

consensus on the appropriate anti-thrombotic regimen in older

patients in atrial fibrillation.

P-397

Four-year prescription trends of profile of antipsychotics use

in patients with dementia

Q. Boucherie

, G. Gentile

, V. Sciortino

, O. Blin

, J. Micallef

S. Bonin-Guillaume

UMR 7289 CNRS Aix MArseille University, Marseille, France;

University department of Genral Medecine, Aix Marseille University,

Marseille, France;

Ersm Cnamts Sud Est, Marseille, France;

Aix

Marseille University, Assistance Publique des Hˆopitaux de Marseille,

Marseille, France

Objectives:

The aim is to describe and compare the profile of

demented patients according to the duration of antipsychotics (AP)

use over a four-year.

Methods:

A retrospective study was conducted from 2009 to

2012 among PACA-Alz Cohort including patients with at least one

reimbursement of anti dementia drugs and/or obtained registration

with the chronic condition ‘Alzheimer’s disease or related diseases’

(n = 33,041 in 2012). According to the maximal AP exposure without

interruption per year, 3 groups of patients were identified: non

users, simple users (maximal exposition without interruption ≤3

months), chronic users (maximal exposition without interruption

3 months).

Results:

Psychotropic drug consumption increased over the study

period (from 68.5% in 2009 to 70.8% in 2012) particularly

Benzodiazepines (from 42.6% to 47.6%). The part of patients who

had at least one AP dispensing was rather stable (from 25.9% to

26.5%); 19.3–14.3% of the patients were AP simple users and 7.3–

12.3% chronic users. In comparison to non users, AP users consumed

more benzodiazepines, antidepressants or memantine. Simple users

were men (OR = 1.2 95% CI[1.1–1.3]) over 85 years old (OR = 1.2

95% CI[1.1–1.2]). Chronic users were similar to other group users

except for BZD (OR = 3.4 95% CI[3.1–3.6]) and anticholinesterases

(OR = 0.9 95% CI[0.8–0.9]).

Conclusion:

The AP consumption in demented patients remains

high but stable over the years despite several warnings. However

few of these patients are long term users. Efforts for AP reduction

should focus for those. Identifying the profile of those should help

doctors in routine practice.

P-398

Medication use in community-dwelling older adults in Bogota,

Colombia

C.A. Cano

, R. Sampert-Ternet

, M.G. Borda

, J. Cabrera Guerra

D. Roselli

, A.J. Arciniegas

Pontificia Universidad Javeriana

–

Hospital San Ignacio, Bogot´a,

Colombia;

Pontificia Universidad Javeriana, Bogota, Colombia

Objective:

To determine the number and type of medications that

are routinely used by a sample of older adults in the capital of

Colombia, and determine how many of those prescriptions are

potentially inappropriate.

Methods:

Data comes from the SABE Bogot ´a Study, a cross-sectional

study conducted in the capital of Colombia in 2012. A total

of 2000 adults aged 60 years and older were interviewed and

sociodemographic, health, cognitive and anthropometric measures

were collected as well as medication use. A multi-stage cluster

sampling methodology was used to select participants.

Results:

A total 1249 female and 751 male subjects answered the

questionnaire, 1514 of them (75.7%) have 5 years of education or

less. Self-reported prevalence of hypertension was 60.0% for women

and 55.4% for men; the prevalence for diabetes was 17.5% for women

and 17.4% for men respectively; 311 subjects (15.6%) were not taking

any medication (range 0–14; median 3). The average number of

medications was higher for women than men (3.5 vs. 2.79) and 548

subjects (27.4%) were receiving 5 medications or more. Of the 6470

medications being used, 443 (6.9%) were potentially inappropriate

according to the Beers criteria.

Conclusion:

Despite the frequency of polypharmacy and potentially

inappropriate medication use in our sample, it is lower than

in previously Latin America studies. Regardless, polypharmacy

remains an important issue among older adults that needs to be

addressed.