The appropriateness of antiplatelet and anticoagulant drug prescriptions in hospitalized patients in an internal medicine ward.
Aging Clin Exp Res
; 33(10): 2849-2855, 2021 Oct.
Article
em En
| MEDLINE
| ID: mdl-31667796
ABSTRACT
BACKGROUND:
Polypharmacy increases the risk of potentially inappropriate prescribing. STOPP&START criteria identify a group of drugs representing inappropriate medication and a group of drugs representing potential prescribing omissions.AIMS:
To evaluate the appropriateness of prescription of antiplatelet and anticoagulant drugs in a sample of patients admitted to an internal medicine ward and their impact on three differentoutcomes:
length of hospitalization, intra-hospital death, and risk of re-admission in the hospital.METHODS:
We analyzed a cohort of 485 inpatients followed for 1 year after discharge from the hospital.RESULTS:
The study sample had a mean age of 70.4 ± 17.6 years, and 48.9% were female. Clinical indication for antiplatelet was not appropriate in 41.2% of the subjects. Anticoagulant therapy was not appropriate in 22.8% of thesubjects:
there was incorrect clinical indication in 5/33 and inappropriate dosing in 28/33. START criteria for antiplatelet drug, but neither STOPP criteria for antiplatelet nor for anticoagulant was positively associated with the length of hospitalization (t = 3.08, p < 0.01). START criteria for anticoagulant medication were associated with greater odds of intra-hospital mortality (OR 5.16, 95% CI 1.92-13.85, p < 0.0001) and with lower odds of re-admission to the hospital within 12 months (OR 0.38, 95% CI 0.18-0.80, p < 0.01).DISCUSSION:
The non-prescription of antiplatelet is associated with longer length of hospitalization. The presence of START criteria for anticoagulant is associated with increased risk of intra-hospital death.CONCLUSIONS:
The appropriateness of prescription is a global burden especially in older subjects, while it increases the risk of fatal and non-fatal complications, side effects, and, consequently, higher health-care costs.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Lista de Medicamentos Potencialmente Inapropriados
/
Anticoagulantes
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article