RESUMO
Objetivo: Analizar la prevalencia de la prescripción potencialmente inadecuada (PPI) en ancianos en Cataluña, utilizando los criterios Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) versión 2. Evaluar la asociación de la PPI con diversas variables (polimedicación, sexo, edad y características sociodemográficas). Material y métodos: Diseño: estudio descriptivo retrospectivo transversal. Emplazamiento: Ámbito de Atención Primaria. Cataluña, España. Participantes Se analizan los datos de la población de 70 años o más atendida en los Centros de Salud de Cataluña en 2014 (700.058 pacientes). Mediciones principales: Cincuenta y cinco indicadores STOPP, y 19 START. Se ajustan modelos de regresión logística para evaluar su asociación con diversas variables. Resultados: La edad media es de 79,2±6,5 años. El 58,5% son mujeres. El 38,7% tiene 7 o más fármacos prescritos, y más del 50% acumulan más de 10 visitas anuales. Los indicadores STOPP que acumulan una mayor PPI son los relacionados con el uso de antiinflamatorios no esteroideos, antiagregantes, anticoagulantes, y benzodiacepinas. En cuanto a los criterios START destaca la omisión de suplementos de vitamina D y calcio, antidepresivos, y fármacos relativos al sistema cardiovascular. La PPI es mayor en mujeres, pacientes institucionalizados y domiciliarios, y en aquellos con mayor número de fármacos y número de visitas. Conclusiones: Se detectó una PPI poblacional con una alta prevalencia (89,6%). La PPI se relaciona de forma más significativa con determinadas condiciones del paciente y grupos farmacológicos. El conocimiento de esta asociación es trascendental para la futura implementación de medidas de seguridad en prescripción farmacológica (AU)
Objective: To measure the prevalence of potentially inappropriate prescribing (PIP) among the elderly population in Catalonia using criteria Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) version 2. In addition, to evaluate the association between PIP and several factors (polypharmacy, gender, age and sociodemographic conditions). Materials and methods: Design: Retrospective cross sectional population study. Settings: Primary Health Care, Catalonia, Spain. Participants: The study population comprised of participants 70 years old and over, who attended primary health care centres in Catalonia in 2014 (700.058 patients). Main analysis: 55 STOPP and 19 START criteria are applied to analyse PIP prevalence. Logistic regression models are adjusted to determine PIP association with several factors. Results: The mean age is 79. 2±6.5. 58.5% being female. 38.7% of patients have 7 or more prescribed drugs, whereas 50% go to a primary care centre 10 or more times during one year. The most frequent PIP among STOPP criteria are related to nonsteroidal anti-inflammatory drug intake, antiplatelet and anticoagulants use, and benzodiazepines. According to START, the most frequent omissions are vitamin D and calcium supplements, antidepressants, and cardiovascular medications. Factors that increase PIP are: female gender, living in a nursing home, receiving home health care, polypharmacy and frequent visits to primary care centres. Conclusions: The overall prevalence of PIP is 89.6%. PPI is significantly related to certain drugs and patient's conditions. The knowledge of this association is important for the implementation of security measures for medical prescription (AU)
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Prescrição Inadequada/estatística & dados numéricos , Lista de Medicamentos Potencialmente Inapropriados , Polimedicação , Estudos Retrospectivos , Estudos Transversais , EspanhaRESUMO
OBJECTIVE: To measure the prevalence of potentially inappropriate prescribing (PIP) among the elderly population in Catalonia using criteria Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) version 2. In addition, to evaluate the association between PIP and several factors (polypharmacy, gender, age and sociodemographic conditions). MATERIALS AND METHODS: Design: Retrospective cross sectional population study. SETTINGS: Primary Health Care, Catalonia, Spain. PARTICIPANTS: The study population comprised of participants 70 years old and over, who attended primary health care centres in Catalonia in 2014 (700.058 patients). MAIN ANALYSIS: 55 STOPP and 19 START criteria are applied to analyse PIP prevalence. Logistic regression models are adjusted to determine PIP association with several factors. RESULTS: The mean age is 79. 2±6.5. 58.5% being female. 38.7% of patients have 7 or more prescribed drugs, whereas 50% go to a primary care centre 10 or more times during one year. The most frequent PIP among STOPP criteria are related to nonsteroidal anti-inflammatory drug intake, antiplatelet and anticoagulants use, and benzodiazepines. According to START, the most frequent omissions are vitamin D and calcium supplements, antidepressants, and cardiovascular medications. Factors that increase PIP are: female gender, living in a nursing home, receiving home health care, polypharmacy and frequent visits to primary care centres. CONCLUSIONS: The overall prevalence of PIP is 89.6%. PPI is significantly related to certain drugs and patient's conditions. The knowledge of this association is important for the implementation of security measures for medical prescription.
