ABSTRACT
Introducción: Objetivo: conocer el porcentaje de prescripciones potencialmente inapropiadas según los criterios STOPP/START en los tratamientos ambulatorios de los pacientes mayores de 65 años que ingresan en una unidad de medicina interna, e identificar los errores de prescripción más frecuentes. Material y métodos: Estudio observacional prospectivo realizado entre octubre y diciembre de 2012. Variables registradas: edad, sexo, índice de comorbilidad de Charlson, motivo de ingreso y tratamiento farmacológico ambulatorio. Resultados: Se recogieron los datos de 131 pacientes (edad media 80,2 años; 58,8% varones, mediana del índice de comorbilidad de Charlson 2; media de medicamentos por paciente: 8,6). Principales motivos de ingreso: descompensación de insuficiencia cardiaca, infección respiratoria, exacerbación de EPOC, infección del tracto urinario, neumonía y síndrome constitucional. Se detectaron 121 prescripciones potencialmente inapropiadas en 73 pacientes (55,7%). Los criterios STOPP más frecuentes fueron las duplicidades terapéuticas. Los criterios START más frecuentes fueron la omisión de estatinas y antiagregantes plaquetarios en la prevención primaria del riesgo cardiovascular en pacientes con diabetes mellitus y al menos un factor de riesgo cardiovascular. Conclusiones: El porcentaje de pacientes con prescripciones inapropiadas encontrado es similar al obtenido en estudios semejantes. Más de la mitad de los pacientes ancianos presentaron al menos una prescripción inapropiada. Esto hace necesario una búsqueda conjunta de errores por exceso y por defecto en la prescripción de fármacos, con el fin de realizar una evaluación más completa de la práctica de prescripción e intentar conseguir la optimización de la terapéutica de los pacientes mayores, especialmente los más frágiles (AU)
Introduction: The aim of this study was to establish the percentage of potentially inappropriate prescriptions, according to STOPP/START criteria, in the ambulatory treatments of patients over65 years admitted to an internal medicine unit, and to identify the most common prescription errors. Material and methods: A prospective, observational study was performed between October and December 2012. The variable recorded were, age, gender, Charlson comorbidity index, reason for hospitalisation and pharmacological ambulatory treatment. Results: Data from 131 patients were collected (Mean age: 80.2 years; 58.8% male, mean Charlson comorbidity index: 2; mean number of medications per patient: 8.6). Main reasons for hospitalisation: decompensated heart failure, respiratory infection, exacerbated COPD, urinary tract infection, pneumonia, and unintended weight loss. There were 121 potentially inappropriate prescriptions detected in 73 patients (55.7%). The most common STOPP criteria were therapeutic duplicities. The most common START criteria were the omission of statins and antiplatelets in primary prevention for cardiovascular risk in patients with diabetes mellitus and at least one cardiovascular risk factor. Conclusions: The percentage of patients with inappropriate prescriptions was similar to those obtained in similar studies. Over 50% of elderly patients had at least one inappropriate prescription. This warrants a joint search for errors by excess and by default in the prescription of medications, with the aim of performing a more complete evaluation of prescription practice and to achieve optimization of therapy in elderly patients, especially the most fragile (AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Medication Errors/statistics & numerical data , Drug Prescriptions/statistics & numerical data , Hospitalization/statistics & numerical data , Aged/statistics & numerical data , Ambulatory Care/statistics & numerical data , Prospective Studies , Chronic Disease/drug therapyABSTRACT
INTRODUCTION: The aim of this study was to establish the percentage of potentially inappropriate prescriptions, according to STOPP/START criteria, in the ambulatory treatments of patients over 65 years admitted to an internal medicine unit, and to identify the most common prescription errors. MATERIAL AND METHODS: A prospective, observational study was performed between October and December 2012. The variable recorded were,age, gender, Charlson comorbidity index, reason for hospitalisation and pharmacological ambulatory treatment. RESULTS: Data from 131 patients were collected (Mean age: 80.2 years; 58.8% male, mean Charlson comorbidity index: 2; mean number of medications per patient: 8.6). Main reasons for hospitalisation: decompensated heart failure, respiratory infection, exacerbated COPD, urinary tract infection, pneumonia, and unintended weight loss. There were 121 potentially inappropriate prescriptions detected in 73 patients (55.7%). The most common STOPP criteria were therapeutic duplicities. The most common START criteria were the omission of statins and antiplatelets in primary prevention for cardiovascular risk in patients with diabetes mellitus and at least one cardiovascular risk factor. CONCLUSIONS: The percentage of patients with inappropriate prescriptions was similar to those obtained in similar studies. Over 50% of elderly patients had at least one inappropriate prescription. This warrants a joint search for errors by excess and by default in the prescription of medications, with the aim of performing a more complete evaluation of prescription practice and to achieve optimization of therapy in elderly patients, especially the most fragile.
