Prescripción inapropiada de fármacos en personas mayores atendidas en un centro de Atención Primaria según los criterios STOPP-START / Inappropriate prescribing of drugs in older people attending primary care health centres: Detection using STOPP-START criteria

Objetivo. Conocer la prevalencia y características de prescripción inapropiada (PI) de los fármacos en los pacientes mayores de 65 años atendidos por un Equipo de Atención Primaria (EAP), utilizando los criterios STOPP-START. Material y método. Estudio transversal de muestra representativa de pacientes mayores de 65 años con historia activa en 2010, atendidos en 13 consultorios urbanos (muestreo sistemático aleatorizado; prevalencia esperada de PI del 40%; precisión: 5%; nivel de confianza: 95%). Se revisó la prescripción en las historias durante 2010, valorando los criterios STOPP-START. Resultados. Se seleccionaron 363 pacientes (56,7% mujeres); con una edad media de 75,2 años (DE: 7,02). Las enfermedades más frecuentes fueron cardiovascular (76,9%) y osteoarticular (57,6%), y el promedio de fármacos en prescripción crónica fue de 4,9 (DE: 3,32). Se detectó PI en 170 pacientes (46,8%, IC 95%: 41,7-52,0%), 42% en varones (IC 95%: 34,3-49,8%) y 46,6% en mujeres (IC 95%: 39,8-53,4%), sin diferencias entre sexos (p = 0,386) y con una mayor prevalencia si hay polimedicación o comorbilidad (p < 0,001). En cuanto al tipo de PI se cumplían criterios STOPP en 131 pacientes (36,1%, IC 95%: 31,1-41,0%) y START en 73 (20,1%, IC 95%: 16-24,2%), sin diferencias entre sexos (p = 0,623 para STOPP; p = 0,678 para START). Las PI STOPP más frecuentes se observan en indicadores del sistema musculoesquelético (50 pacientes: 38,2%, IC 95%: 29,8-46,5%) y las START en indicadores de endocrinología (38 pacientes: 52,1%, IC 95%: 40,0-63,9%). Conclusiones. La herramienta STOPP-START permite detectar y sistematizar la aplicación de criterios de PI en un porcentaje elevado de pacientes mayores atendidos por un EAP, pudiendo promover estrategias de mejora de la prescripción (AU)

ObjectiveTo determine the prevalence and characteristics of inappropriate prescribing of drugs (IP) in patients >65 years-old evaluated by a primary care team (PCT), using the STOPP-START criteria.Material and methodCross-sectional sample of patients older than 65 years-old with active clinical history in 2010, and who were attended in 13 urban clinics (systematic random sampling, expected IP prevalence of 40%, precision: 5% confidence level: 95%). Requirement was reviewed clinical histories in 2010, using the STOPP-START criteria.ResultsA total of 363 patients were selected (56.7% women), mean age 75.2 years (SD: 7.02). The most frequent diseases were cardiovascular (76.9%) and osteoarticular (57.6%) diseases, and the average number of prescription drugs was 4.9 (SD: 3.32). IP was detected in 170 patients (46.8%; 95% CI: 41.7-52.0%), 42% in men (95% CI: 34.3-49.8%) and 46.6% in women (95% CI: 39.8-53.4%), with no differences between sexes (P=.386), with a higher prevalence if polypharmacy or comorbidity were present (P<.001). The STOPP criteria were met in 131 patients (36.1%; 95% CI: 31.1-41.0%), and START criteria in 73 (20.1%; 95% CI: 16-24.2%), with no difference between sexes (P=.623 for STOPP, and P=.678 for START). The most frequent STOPP criteria were observed in the musculoskeletal system (50 patients, 38.2%; 95% CI: 29.8-46.5%) and START endocrinology indicators (38 patients, 52.1%; 95% CI: 40.0-63.9%).ConclusionsThe STOPP-START tool detected and systematised IP in a high percentage of elderly patients treated by a PCT, and can promote improvement in prescribing strategies (AU)

[Inappropriate prescribing of drugs in older people attending primary care health centres: detection using STOPP-START criteria]. / Prescripción inapropiada de fármacos en personas mayores atendidas en un centro de Atención Primaria según los criterios STOPP-START.

OBJECTIVE: To determine the prevalence and characteristics of inappropriate prescribing of drugs (IP) in patients >65 years-old evaluated by a primary care team (PCT), using the STOPP-START criteria. MATERIAL AND METHOD: Cross-sectional sample of patients older than 65 years-old with active clinical history in 2010, and who were attended in 13 urban clinics (systematic random sampling, expected IP prevalence of 40%, precision: 5% confidence level: 95%). Requirement was reviewed clinical histories in 2010, using the STOPP-START criteria. RESULTS: A total of 363 patients were selected (56.7% women), mean age 75.2 years (SD: 7.02). The most frequent diseases were cardiovascular (76.9%) and osteoarticular (57.6%) diseases, and the average number of prescription drugs was 4.9 (SD: 3.32). IP was detected in 170 patients (46.8%; 95% CI: 41.7-52.0%), 42% in men (95% CI: 34.3-49.8%) and 46.6% in women (95% CI: 39.8-53.4%), with no differences between sexes (P=.386), with a higher prevalence if polypharmacy or comorbidity were present (P<.001). The STOPP criteria were met in 131 patients (36.1%; 95% CI: 31.1-41.0%), and START criteria in 73 (20.1%; 95% CI: 16-24.2%), with no difference between sexes (P=.623 for STOPP, and P=.678 for START). The most frequent STOPP criteria were observed in the musculoskeletal system (50 patients, 38.2%; 95% CI: 29.8-46.5%) and START endocrinology indicators (38 patients, 52.1%; 95% CI: 40.0-63.9%). CONCLUSIONS: The STOPP-START tool detected and systematised IP in a high percentage of elderly patients treated by a PCT, and can promote improvement in prescribing strategies.