Consumo de antibióticos en pediatría de atención primaria antes y durante la pandemia de COVID-19 / Use of antibiotics in Paediatric Primary Health Care before and during the COVID-19 pandemic

Introducción: En España existe un alto consumo de antibióticos, especialmente en los primeros años de vida. Un uso excesivo de antimicrobianos contribuye a la aparición de resistencias. El objetivo de este estudio es analizar la evolución del consumo de antibióticos en población pediátrica entre 2014 y 2021 en la atención primaria del Principado de Asturias, y estudiar el impacto de la pandemia por COVID-19 sobre el mismo. Métodos: Estudio observacional y retrospectivo que recoge las prescripciones de antibacterianos para uso sistémico dispensadas a partir de recetas oficiales emitidas para pacientes menores de 14 años en atención primaria. Se mide el consumo en dosis diarias definidas (DDD) por 1.000 habitantes y día (DHD). Resultados: La tasa de consumo de antibióticos descendió desde 13,9DHD en 2014 a 4,0 en 2021 (β=−1,42; p=0,002) con un punto de inflexión en el año 2019. Entre 2019 y 2020 el descenso fue del 47,1%. El consumo se mantuvo en niveles muy bajos entre abril de 2020 y septiembre de 2021, con un repunte contenido desde octubre de 2021. La prevalencia de uso de antibióticos cayó desde el 39,9% en 2014 al 17,5% en 2021 (β=−3,64; p=0,006). Disminuyó el consumo relativo de amoxicilina-clavulánico y aumentó el de amoxicilina y cefalosporinas de tercera generación. Conclusión: En Asturias, el consumo pediátrico de antibióticos en atención primaria se desplomó a partir de 2020, coincidiendo con la COVID-19. La monitorización de estos indicadores permitirá comprobar en qué medida se mantienen los cambios en el tiempo.(AU)

Introduction: Consumption of antibiotics is high in Spain, primarily in children. Excessive use of then contributes to the development of antimicrobial resistance. The aim of our study is to analyse the evolution of antibiotic consumption at the Primary Health Care in the paediatric population of Asturias, Spain, from 2014 to 2021, and to evaluate the impact of COVID-19 pandemic on it. Methods: Retrospective and observational study using data about antibacterial agents for systemic use dispensed for official prescriptions to children under 14 years in Primary Care. Antibiotic consumption is expressed as defined daily dose (DDD) per 1000 inhabitants per day (DID). Results: The antibiotic consumption rate dropped from 13.9 DID in 2014 to 4.0 in 2021 (β=−1.42, P=.002), with and inflection point in 2019. From 2019 to 2020 antibiotic use dropped by 47.1%. Antibiotic consumption remained very low from April 2020 to September 2021, and then moderately increased from October 2021. Prevalence of antibiotic use dropped from 39.9% in 2014 to 17.5% in 2021 (β=−3.64, P=.006). Relative consumption of amoxicillin/clavulanic acid decreased, while those of amoxiciline and third-generation cephalosporins increased. Conclusions: Paediatric antibiotic consumption collapsed in Asturias in 2020, coinciding with COVID-19 pandemic. Monitoring of antimicrobial usage indicators will allow to check if these changes are sustained over time.(AU)

Use of antibiotics in Paediatric Primary Health Care before and during the COVID-19 pandemic.

INTRODUCTION: Consumption of antibiotics is high in Spain, primarily in children. Excessive use of then contributes to the development of antimicrobial resistance. The aim of our study is to analyse the evolution of antibiotic consumption at the Primary Health Care in the paediatric population of Asturias, Spain, from 2014 to 2021, and to evaluate the impact of COVID-19 pandemic on it. METHODS: Retrospective and observational study using data about antibacterial agents for systemic use dispensed for official prescriptions to children under 14 years in Primary Care. Antibiotic consumption is expressed as defined daily dose (DDD) per 1000 inhabitants per day (DID). RESULTS: The antibiotic consumption rate dropped from 13.9 DID in 2014 to 4.0 in 2021 (ß=-1,42, p=0,002), with and inflection point in 2019. From 2019 to 2020 antibiotic use dropped by 47.1%. Antibiotic consumption remained very low from April 2020 to September 2021, and then moderately increased from October 2021. Prevalence of antibiotic use dropped from 39.9% in 2014 to 17.5% in 2021 (ß=-3,64, p=0,006). Relative consumption of amoxicillin/clavulanic acid decreased, while those of amoxiciline and third-generation cephalosporins increased. CONCLUSIONS: Paediatric antibiotic consumption collapsed in Asturias in 2020, coinciding with COVID-19 pandemic. Monitoring of antimicrobial usage indicators will allow to check if these changes are sustained over time.

Consumo de antibióticos en atención primaria en población adulta de Asturias durante el periodo 2014-2020 / Antibiotic consumption in primary care in the adult population of Asturias during 2014–2020 period

Objetivo: Estudiar la evolución del consumo de antibióticos en población adulta en el ámbito de Atención Primaria (AP) del Servicio de Salud del Principado de Asturias (SESPA) durante 2014-2020.DiseñoEstudio observacional retrospectivo.EmplazamientoAP del SESPA.ParticipantesPoblación de la base de datos de Tarjeta Sanitaria Individual.IntervencionesSe recogieron datos de prescripción de antibióticos, realizada en las consultas de medicina de familia, dispensados en las oficinas de farmacia con cargo al SESPA. Se analizaron variables de uso y consumo de antibióticos mediante modelos de regresión lineal.Mediciones principalesPrevalencia de uso de antibióticos (porcentaje población); tasa de consumo de antibióticos de uso sistémico (DTD), consumo relativo de antibióticos de espectro reducido (porcentaje DDD).ResultadosLa prevalencia media del uso de antibióticos del periodo 2014-2019 fue de 32,2% y 23,9% en 2020. La tasa de consumo de antibióticos de uso sistémico pasó de 21,4 DTD en 2014 a 12,7 DTD en 2020. El consumo de antibióticos de espectro reducido se mantuvo estable (19,4% DDD en 2014 y 19,3% DDD en 2020) (IC95: -0,10, 0,26). En el periodo de marzo a diciembre de 2020, el consumo de antibióticos se redujo un 28,6% respecto al mismo periodo de 2019.ConclusionesEn 2014-2020 el consumo de antibióticos disminuyó, especialmente a partir de la pandemia por COVID-19, con estabilización del consumo de antibióticos de espectro reducido respecto al total. Existe variabilidad en el consumo por subgrupos terapéuticos.

Trend study of the consumption of systemic antibiotics in the adult population in of Primary Care of the Health Service of the Principality of Asturias (SESPA) during the period 2014̶2020. Retrospective observational study. SESPA, Primary Care. Population from the Individual Health Card database. Data were collected on the prescription of antibiotics, carried out in the family medicine consultations, dispensed in the pharmacy offices with charge of SESPA. Antibiotic use and consumption variables were analyzed using linear regression models. Prevalence of antibiotic use (population percentage); consumption rate of systemic antibiotics (DTD), relative consumption of narrow-spectrum antibiotics (percentage DDD). The average prevalence of the use of antibiotics for the 2014̶2019 period was 32.2% and 23.9% in 2020. The rate of consumption of systemic antibiotics decreased from 21.4 DTD in 2014 to 12.7 DTD in 2020. The consumption of narrow-spectrum antibiotics remained stable (19.4% DDD in 2014 and 19.3% DDD in 2020) (CI95: −0.10, 0.26). In the period from March to December 2020, the consumption of antibiotics decreased by 28.6% compared to the same period in 2019. In 2014̶2020, the consumption of antibiotics decreased, especially since the COVID-19 pandemic, with stabilization of the consumption of narrow-spectrum antibiotics compared to the total. There is variability in consumption by therapeutic subgroups.

[Antibiotic consumption in primary care in the adult population of Asturias during 2014-2020 period]. / Consumo de antibióticos en atención primaria en población adulta de Asturias durante el periodo 2014-2020.

Trend study of the consumption of systemic antibiotics in the adult population in of Primary Care of the Health Service of the Principality of Asturias (SESPA) during the period 2014̶2020. Retrospective observational study. SESPA, Primary Care. Population from the Individual Health Card database. Data were collected on the prescription of antibiotics, carried out in the family medicine consultations, dispensed in the pharmacy offices with charge of SESPA. Antibiotic use and consumption variables were analyzed using linear regression models. Prevalence of antibiotic use (population percentage); consumption rate of systemic antibiotics (DTD), relative consumption of narrow-spectrum antibiotics (percentage DDD). The average prevalence of the use of antibiotics for the 2014̶2019 period was 32.2% and 23.9% in 2020. The rate of consumption of systemic antibiotics decreased from 21.4 DTD in 2014 to 12.7 DTD in 2020. The consumption of narrow-spectrum antibiotics remained stable (19.4% DDD in 2014 and 19.3% DDD in 2020) (CI95: -0.10, 0.26). In the period from March to December 2020, the consumption of antibiotics decreased by 28.6% compared to the same period in 2019. In 2014̶2020, the consumption of antibiotics decreased, especially since the COVID-19 pandemic, with stabilization of the consumption of narrow-spectrum antibiotics compared to the total. There is variability in consumption by therapeutic subgroups.

Los criterios STOPP/START más frecuentes en España. Una revisión de la literatura / The most common STOPP/START criteria in Spain. A review of the literature

Objetivo: Analizar los criterios STOPP/START encontrados con más frecuencia en los estudios llevados a cabo en España, con el fin de identificar las áreas principales de prescripción potencialmente inadecuada. Métodos: Revisión de la literatura de los estudios originales realizados en España que aplicaron los criterios STOPP/START, versión 2008, y que describían los criterios STOPP o START más comunes. En cada estudio, se realizó un análisis ponderado de los criterios encontrados, asignando una puntuación 5 al criterio encontrado en la primera posición, 4 al criterio en segunda posición y así sucesivamente hasta el quinto criterio. Posteriormente se obtuvieron las puntuaciones totales para cada criterio analizado. Resultados: Se seleccionaron 19 estudios originales que analizaban los criterios STOPP, de los cuales 14 analizaban también todos los criterios START. Del total de estudios, 11 se desarrollaron en atención extrahospitalaria y 8 en atención hospitalaria. El criterio STOPP con la valoración ponderada más alta fue el B7 (uso prolongado de benzodiacepinas de vida media larga), seguido del J (cualquier prescripción regular de 2fármacos de la misma clase). El criterio START con la valoración ponderada más alta fue el F4 (estatinas en la diabetes mellitus si coexisten uno o más factores mayores de riesgo cardiovascular), seguido del E3 (suplementos de calcio y vitamina D en pacientes con osteoporosis conocida [con evidencia radiológica o fractura por fragilidad previa o cifosis dorsal adquirida]). Conclusiones: Las áreas de prescripción potencialmente inadecuada están bien definidas y sañalan la pertinencia de intervención en algunos puntos terapéuticos concretos

Objective: To analyse STOPP/START criteria found most frequently in the studies carried out in Spain, in order to identify the main areas of potentially inappropriate prescribing. Methods: A literature review was carried out on the original studies performed in Spain that applied the original version of the STOPP/START criteria and that described the most common STOPP and/or START criteria found. In each study, a weighted analysis was performed on the criteria found, by assigning 5 points to the criterion in first position, 4 points to the criterion in second position, and so on to fifth criterion. The total points of each analysed criterion were then obtained. Results: A total of 19 original studies analysing STOPP criteria were selected, 14 of them also studying all START criteria. From the total of studies, 11 were developed in out-of-hospital care, and 8 in hospital care. The STOPP criterion with the highest weighted assessment was B7 (long-term, long-acting benzodiazepines), followed by J (any duplicate drug class prescription). The START criterion with the highest weighted assessment was F4 (statin therapy in diabetes mellitus if coexisting major cardiovascular risk factors present), followed by E3 (calcium and vitamin D supplement in patients with known osteoporosis: previous fragility fracture, acquired dorsal kyphosis). Conclusions: The most common areas of potentially inappropriate prescribing are well defined, and suggest a particular intervention in some specific therapeutic points

[The most common STOPP/START criteria in Spain. A review of the literature]. / Los criterios STOPP/START más frecuentes en España. Una revisión de la literatura.

OBJECTIVE: To analyse STOPP/START criteria found most frequently in the studies carried out in Spain, in order to identify the main areas of potentially inappropriate prescribing. METHODS: A literature review was carried out on the original studies performed in Spain that applied the original version of the STOPP/START criteria and that described the most common STOPP and/or START criteria found. In each study, a weighted analysis was performed on the criteria found, by assigning 5 points to the criterion in first position, 4 points to the criterion in second position, and so on to fifth criterion. The total points of each analysed criterion were then obtained. RESULTS: A total of 19 original studies analysing STOPP criteria were selected, 14 of them also studying all START criteria. From the total of studies, 11 were developed in out-of-hospital care, and 8 in hospital care. The STOPP criterion with the highest weighted assessment was B7 (long-term, long-acting benzodiazepines), followed by J (any duplicate drug class prescription). The START criterion with the highest weighted assessment was F4 (statin therapy in diabetes mellitus if coexisting major cardiovascular risk factors present), followed by E3 (calcium and vitamin D supplement in patients with known osteoporosis: previous fragility fracture, acquired dorsal kyphosis). CONCLUSIONS: The most common areas of potentially inappropriate prescribing are well defined, and suggest a particular intervention in some specific therapeutic points.

Updated 2014 STOPP criteria to identify potentially inappropriate prescribing in community-dwelling elderly patients
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OBJECTIVE: To analyze potentially inappropriate prescribing (PIP) using the 2014 version of STOPP criteria. MATERIALS AND METHODS: Prescriptions were analyzed by using invoicing data and electronic medical records. RESULTS: At least one STOPP criterion was observed in 9 out of every 10 patients. The most common STOPP criteria found were: "any drug prescribed without an evidence-based clinical indication" and "any drug prescribed beyond the recommended duration, where treatment duration is well defined". CONCLUSION: The high prevalence of PIP found seems to be due to the inclusion of new criteria related to indication of medication and duration of treatments.
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Efecto de la crisis económica sobre el consumo de psicofármacos en Asturias / Effect of the economic crisis on consumption of psychotropic drugs in Asturias (Spain)

Objetivo: Evaluar si la crisis económica de 2008ha comportado cambios en la evolución del consumo de ansiolíticos, hipnótico-sedantes y antidepresivos en Asturias. Método: Estudio descriptivo y de utilización de medicamentos durante 2003-2013. Se calcularon las dosis diarias definidas por 1000 habitantes/día (DHD) de ansiolíticos, hipnótico-sedantes y antidepresivos. Se obtuvieron coeficientes de regresión lineal (b) de las DHD de la etapa precrisis (2003-2008) y de la etapa de crisis (2009-2013). Resultados: El consumo de ansiolíticos creció un 40,25%, el de hipnóticos un 88,11% y el de antidepresivos un 80,93%. Para los ansiolíticos: b-(2003-2008)=4,38 DHD/año y b-(2009-2013)=1,08 DHD/año. Para los hipnótico-sedantes: b-(2003-2008)=2,30 DHD/año y b-(2009-2013)=0,40 DHD/año. Para los antidepresivos: b-(2003-2008)=5,79 DHD/año y b-(2009-2013)=2,83 DHD/año. Conclusiones: El incremento del consumo para los tres subgrupos en la época de crisis fue menor que en la época precrisis. No se confirma que la crisis económica haya influido aumentando el consumo de estos medicamentos (AU)

Objective: To assess whether the economic crisis of 2008 has changed the consumption of anxiolytics, hypnotics-sedatives and antidepressants in Asturias (Spain). Method: We conducted a descriptive study of drug use from 2003 -2013. The defined daily doses of 1000 inhabitants per day (DHD) were calculated for anxiolytics, hypnotics-sedatives and antidepressants. Linear regression coefficients (b) of the DHD were obtained for the pre-crisis period (2003-2008) and the crisis period (2009-2013). Results: The consumption of anxiolytics increased by 40.25%, that of hypnotics by 88.11% and that of antidepressants by 80.93%. For anxiolytics: b-(2003-2008)=4.38 DDI/year and b-(2009-2013)=1.08 DDI/year. For hypnotics-sedatives: b-(2003-2008)=2.30 DDI/year and b-(2009-2013)=0.40 DDI/year. For antidepressants: b-(2003-2008)=5.79 DDI/year and b-(2009-2013)=2.83 DDI/year. Conclusions: The rise in consumption of the three subgroups during the crisis period was lower than that of the pre-crisis period. This study does not confirm the influence of the economic crisis on the rise in consumption of these drugs (AU)

Beers versus STOPP criteria in polyharmacy community-dwelling older patients / Criterios de Beers versus STOPP en pacientes mayores, polimedicados y residentes en la comunidad

Objective: To assess potentially inappropriate prescribing (PIP) using Beers (2012 version) and STOPP (2008 version) criteria in polypharmacy, community-dwelling, older patients. Methods: From the information collected in the invoicing data of the prescriptions and the electronic medical records, a sample was selected of 223 greater than or equal to 65-year-old patients who were taking simultaneously 10 or more drugs per day. Beers and STOPP criteria were separately applied, and the results obtained with the two methods were compared. Results: A total of 141 (63.2%) patients presented at least one Beers criterion. The two most frequently observed Beers criteria independent of diagnosis were the use of benzodiazepines and the use of non-COX-2-selective non-steroidal anti-inflammatory drugs. With regard to Beers criteria considering diagnosis, the most frequent were the use of anticholinergic drugs in patients with lower urinary tract symptoms or benign prostatic hyperplasia, and the use of benzodiazepines, antipsychotics, zolpidem or H2 -antihistamines, in patients with dementia or cognitive impairment. A total of 165 (73.9%) patients had at least one PIP according to the STOPP criteria. Duplicate drug classes and long-term use of long-acting benzodiazepines were the two most frequent STOPP criteria. Discussion: Our study identified a high frequency of PIP in polymedicated community-dwelling older patients. Simultaneous application of Beers and STOPP criteria represents a useful tool to improve prescribing in this population group (AU))

Objetivo: Evaluar la prescripción potencialmente inapropiada (PPI) mediante la aplicación de los criterios Beers (versión 2012) y STOPP (versión 2008) en pacientes mayores, polimedicados y residentes en la comunidad. Métodos: A partir de la información recogida en los datos de facturación de recetas y de las historias clínicas electrónicas se seleccionó una muestra de 223 pacientes de 65 o más años, que tomaban simultáneamente 10 o más medicamentos/día. Se aplicaron separadamente los criterios de Beers y STOPP y se compararon los resultados obtenidos con ambos métodos. Resultados: Un total de 141 pacientes (63,2%) presentaban al menos un criterio de Beers. Los dos criterios de Beers independientes del diagnóstico observados con más frecuencia fueron el uso de benzodiazepinas y el uso de antiinflamatorios no esteroideos no selectivos de ciclooxigenasa-2. Con respecto a los criterios de Beers considerando el diagnóstico, los más frecuentes fueron el uso de anticolinérgicos en pacientes con síntomas del tracto urinario inferior o con hiperplasia benigna de próstata y el uso de benzodiazepinas, antipsicóticos, zolpidem o antihistamí- nicos H2 , en pacientes con demencia o deterioro cognitivo. Un total de 165 (73,9%) pacientes tenían al menos una PPI según los criterios STOPP. La duplicidad terapéutica y el uso prolongado de benzodiazepinas de vida media larga fueron los dos criterios STOPP más comunes. Discusión: Nuestro estudio identificó una alta frecuencia de PPI en pacientes mayores, polimedicados y residentes en la comunidad. La aplicación simultánea de los criterios de Beers y STOPP constituye una herramienta útil para mejorar la prescripción en este grupo de población (AU)

Beers versus STOPP criteria in polyharmacy community-dwelling older patients.

OBJECTIVE: To assess potentially inappropriate prescribing (PIP) using Beers (2012 version) and STOPP (2008 version) criteria in polypharmacy, community-dwelling, older patients. METHODS: From the information collected in the invoicing data of the prescriptions and the electronic medical records, a sample was selected of 223 ≥ 65-year-old patients who were taking simultaneously 10 or more drugs per day. Beers and STOPP criteria were separately applied, and the results obtained with the two methods were compared. RESULTS: A total of 141 (63.2%) patients presented at least one Beers criterion. The two most frequently observed Beers criteria independent of diagnosis were the use of benzodiazepines and the use of non-COX-2-selective non-steroidal anti-inflammatory drugs. With regard to Beers criteria considering diagnosis, the most frequent were the use of anticholinergic drugs in patients with lower urinary tract symptoms or benign prostatic hyperplasia, and the use of benzodiazepines, antipsychotics, zolpidem or H2-antihistamines, in patients with dementia or cognitive impairment. A total of 165 (73.9%) patients had at least one PIP according to the STOPP criteria. Duplicate drug classes and long-term use of long-acting benzodiazepines were the two most frequent STOPP criteria. DISCUSSION: Our study identified a high frequency of PIP in polymedicated community-dwelling older patients. Simultaneous application of Beers and STOPP criteria represents a useful tool to improve prescribing in this population group.

Objetivo: Evaluar la prescripcion potencialmente inapropiada (PPI) mediante la aplicacion de los criterios Beers (version 2012) y STOPP (version 2008) en pacientes mayores, polimedicados y residentes en la comunidad. Metodos: A partir de la informacion recogida en los datos de facturacion de recetas y de las historias clinicas electronicas se selecciono una muestra de 223 pacientes de 65 o mas anos, que tomaban simultaneamente 10 o mas medicamentos/dia. Se aplicaron separadamente los criterios de Beers y STOPP y se compararon los resultados obtenidos con ambos metodos. Resultados: Un total de 141 pacientes (63,2%) presentaban al menos un criterio de Beers. Los dos criterios de Beers independientes del diagnostico observados con mas frecuencia fueron el uso de benzodiazepinas y el uso de antiinflamatorios no esteroideos no selectivos de ciclooxigenasa-2. Con respecto a los criterios de Beers considerando el diagnostico, los mas frecuentes fueron el uso de anticolinergicos en pacientes con sintomas del tracto urinario inferior o con hiperplasia benigna de prostata y el uso de benzodiazepinas, antipsicoticos, zolpidem o antihistaminicos H2, en pacientes con demencia o deterioro cognitivo. Un total de 165 (73,9%) pacientes tenian al menos una PPI segun los criterios STOPP. La duplicidad terapeutica y el uso prolongado de benzodiazepinas de vida media larga fueron los dos criterios STOPP mas comunes. Discusion: Nuestro estudio identifico una alta frecuencia de PPI en pacientes mayores, polimedicados y residentes en la comunidad. La aplicacion simultanea de los criterios de Beers y STOPP constituye una herramienta util para mejorar la prescripcion en este grupo de poblacion.

[Effect of the economic crisis on consumption of psychotropic drugs in Asturias (Spain)]. / Efecto de la crisis económica sobre el consumo de psicofármacos en Asturias.

OBJECTIVE: To assess whether the economic crisis of 2008 has changed the consumption of anxiolytics, hypnotics-sedatives and antidepressants in Asturias (Spain). METHOD: We conducted a descriptive study of drug use from 2003 -2013. The defined daily doses of 1000 inhabitants per day (DHD) were calculated for anxiolytics, hypnotics-sedatives and antidepressants. Linear regression coefficients (b) of the DHD were obtained for the pre-crisis period (2003-2008) and the crisis period (2009-2013). RESULTS: The consumption of anxiolytics increased by 40.25%, that of hypnotics by 88.11% and that of antidepressants by 80.93%. For anxiolytics: b-(2003-2008)=4.38 DDI/year and b-(2009-2013)=1.08 DDI/year. For hypnotics-sedatives: b-(2003-2008)=2.30 DDI/year and b-(2009-2013)=0.40 DDI/year. For antidepressants: b-(2003-2008)=5.79 DDI/year and b-(2009-2013)=2.83 DDI/year. CONCLUSIONS: The rise in consumption of the three subgroups during the crisis period was lower than that of the pre-crisis period. This study does not confirm the influence of the economic crisis on the rise in consumption of these drugs.

Optimización de la información sobre la medicación de personas polimedicadas en atención primaria / Optimization of information on the medication of polypharmacy patients in primary care

Dentro del protocolo de pacientes polimedicados/as elaborado por el Servicio de Salud del Principado de Asturias, los/las médicos/as de atención primaria reciben periódicamente los listados de los tratamientos de pacientes de cualquier edad que consumen 10 o más medicamentos/día durante un período de 6 meses. Actualmente, el Servicio de Salud del Principado de Asturias está desarrollando un proyecto orientado a evaluar las medicaciones de pacientes polimedicados/as, con el fin de identificar: 1) el consumo de medicamentos de utilidad terapéutica baja, 2) el consumo de fármacos potencialmente nefrotóxicos en pacientes con filtrado glomerular disminuido, y 3) la posible prescripción inadecuada en pacientes mayores de 65 años. El proyecto se inició con una primera fase llevada a cabo en el Área Sanitaria II y actualmente se pretende extenderlo a las áreas sanitarias restantes. Consideramos que su automatización y aplicación generalizada podrían ser útiles para optimizar la prescripción de medicamentos (AU)

As part of the protocol of the Health Service of the Principality of Asturias (Spain), primary care physicians periodically receive listings of the treatments of patients of any age taking 10 or more drugs/day for 6 months. Currently, the Health Service of the Principality of Asturias is developing a project that aims to assess the medications of polypharmacy patients. The aim is to identify: 1) the consumption of medicines of low therapeutic usefulness, 2) the consumption of potentially nephrotoxic drugs in patients with a low glomerular filtration rate, and 3) potentially inappropriate prescribing in patients aged 65 years or older. The project was started in Health Area II and the aim is to extend it to the remaining health areas. In our opinion, its automation and general implementation could be useful to optimize drug prescription (AU)

Inappropriate prescribing in polypharmacy elderly outpatients taking multiple medications. Are the STOPP criteria useful?

OBJECTIVE: To assess potentially inappropriate medications (PIMs) in elderly outpatients taking multiple medications. METHODS: Invoicing data of the prescriptions and electronic medical records were used to apply the STOPP (screening tool of older people's prescriptions) criteria. RESULTS: Three out of 4 patients included in the study received PIMs. The most common criteria found were: duplicate drug class prescriptions (n = 58 (17.4%)), long-term long-acting benzodiazepines (n = 54 (16.2%)), and acetylsalicylic acid with no history of coronary, cerebral, or peripheral vascular symptoms or occlusive event (n = 32 (9.6%)). CONCLUSION: Our results highlight the relevance of the systematic review of the pharmacological treatments in these patients.

[Optimization of information on the medication of polypharmacy patients in primary care]. / Optimización de la información sobre la medicación de personas polimedicadas en atención primaria.

As part of the protocol of the Health Service of the Principality of Asturias (Spain), primary care physicians periodically receive listings of the treatments of patients of any age taking 10 or more drugs/day for 6 months. Currently, the Health Service of the Principality of Asturias is developing a project that aims to assess the medications of polypharmacy patients. The aim is to identify: 1) the consumption of medicines of low therapeutic usefulness, 2) the consumption of potentially nephrotoxic drugs in patients with a low glomerular filtration rate, and 3) potentially inappropriate prescribing in patients aged 65 years or older. The project was started in Health Area II and the aim is to extend it to the remaining health areas. In our opinion, its automation and general implementation could be useful to optimize drug prescription.