293 PRE-ADMISSION POTENTIALLY INAPPROPRIATE PRESCRIBING PREVALENCE ON A CARE OF THE OLDER ADULT MEDICAL WARD

Abstract

Abstract Background Potentially Inappropriate Prescribing (PIP) is a common but critical issue in care of the older adult. It is estimated that between 50 and 70% of those over 65 years are receiving at least one potentially inappropriate medication. Polypharmacy is a good indicator of PIP as it can indicate over- and inappropriate prescribing through prescribing cascade, exposing patients to risks of drug interactions and Adverse Drug Events (ADEs). 10-20% of hospital admissions of older adults are directly related to ADE of inappropriately prescribed drugs. Methods Point prevalence study using the ‘Screening Tool of Older Persons Prescriptions’ (STOPP) to identify PIPs on a geriatric medicine ward. Patients over 65 years of age admitted from home were included in the study. Patients’ pre-admission medications and changes made to these were assessed using STOPP. Results Sixteen patients out of 22 met the inclusion criteria. The average age of the patients included in the study was 82.3 years with a range from 70 to 88 years. 75% were female. 94% had polypharmacy prior to admission with an average of 2.25 PIPs (range 0 to 5). 43% (n=7) had all their PIPs addressed by a geriatrician as per STOPP, with a further 18% (n=3) having some of their PIPs altered. 25% (n=4) did not have any alterations to their PIPs. Conclusion Despite widely known impacts of PIPs on older adults, PIP remains highly prevalent in those admitted to hospital. PIP and polypharmacy can increase incident frailty two-fold and polypharmacy and frailty can lead to a 6-fold increase in mortality within two and a half years. We must actively educate all those involved in prescribing for this cohort of patients to reduce PIPs and their adverse effects.