Analysis of drug prescriptions of patients with atrial fibrillation in combination with chronic kidney disease for compliance with STOPP/START criteria

Abstract

The percentage of elderly and senile patients is growing every year. Among this cohort of patients, atrial fibrillation (AF) is one of the most common rhythm disorders. At the same time, AF repeatedly increases the risk of thromboembolic complications. The course of AF in elderly patients is often complicated by chronic kidney disease (CKD). When managing patients of this group, we often encounter polypragmasia, which affects the patient’s quality of life, increases the risk of falls, and potentially reduces life expectancy. In order to optimize pharmacotherapy, STOPP/ START criteria were developed.The purpose of the study was the analysis of drug prescriptions in patients over 65 years of age with AF and CKD for compliance with the STOPP/ START criteria.Material and methods. 339 case histories of the cardiology department and 180 case histories of patients of the therapeutic department of the Veterans of Wars multidisciplinary hospital were analyzed. In each department, patients were divided into 2 groups: patients with AF in combination with CKD C3a and patients with AF in combination with CKD C3b and C4.Results. In the therapeutic department, 96.1% of the first group and 100.0% of the second group of patients were not prescribed drugs that are recommended for elderly patients (START criteria). 64.7% of patients from the first group and 53.8% of patients from the second group have potentially not recommended, but prescribed drugs (STOPP criteria) in the appointment lists In the cardiology department, the percentage of patients who did not have the recommended drugs (START criteria) in drug therapy was 92% in group 3, 97% in group 4. The percentage of patients who were prescribed potentially non-recommended drugs (STOP criteria) in group 3 45%, in group 4 48%.Conclusion. Most elderly and senile patients with AF in combination with CKD have both START and STOPP criteria, which dictates a thorough analysis of the prescribed drug therapy.