Abstract
Potential prescribing omission (PPO) represents a failure in prescribing drugs when indicated due to lack of the evidence base. Published data are scarce on the prevalence of prescribing omissions in Jordan. This study aimed to assess the prevalence of prescribing omissions in elderly patients in a Jordanian teaching hospital. Screening Tool to Alert doctors to the Right Treatment (START) version 2 was used to identify the prescribing omissions in older adults admitted to a tertiary hospital in Jordan for 18 months. During the study period, data relating to the patients’ medical problems and prescribed medicines were collected by two clinical pharmacists via reviewing the clinical and prescription records of the included patients. Data were collected using a predefined data collection form and statistical analysis was conducted using Statistical Package of Social Sciences (SPPSS). One or more prescribing omissions were found in 40.5%, 41.0%, and 39.5% of the patients upon admission, during hospitalization, and on discharge, respectively. The most common prescribing omission was about START criterion I1 which was “seasonal trivalent influenza vaccine annually” in 54.8% upon admission, 51.5% during hospitalization, and 51.9% on discharge. Logistic regression found that the higher number of medical conditions was associated with an increased risk of PPO occurrence upon admission, during hospitalization, and on discharge (p value < 0.05). Acts of omission of appropriate medications were highly prevalent among older patients in our hospital setting. A validated screening tool (START) is one method of systematically identifying appropriate omitted medicines in clinical practice. Application of validated START criteria can help detect and prevent PPO occurrence among older patients
Highlights
Altering medications is the most common health intervention in modern healthcare systems (NICE, 2015)
Recent studies in Jordan showed that drug prescribing omission was one of the major errors detected in implementing the medication reconciliation process in different settings (Abu Farha et al, 2018; Abu Hammour and Abdel Jalil, 2016; Salameh et al, 2019)
The results indicated high prevalence of identified cases of Potential prescribing omission (PPO) among the study population during their hospital stay
Summary
Altering medications is the most common health intervention in modern healthcare systems (NICE, 2015). Hospitalized patients worldwide are prone to many threats that may impose actual harm to their health, one of them being the act of inappropriately prescribing medications (Cheragi et al, 2013; Kothari et al, 2010), and Jordan is no exception. Data are limited regarding using the screening tools to assess prescribing omissions in this group of patients (Alice Oborne et al, 2003; Batty et al, 2003). This could result from the lack of appropriate screening tools. Researchers developed the Screening Tool to Alert doctors to the Right Treatment (START) criteria for detecting potential prescribing omissions (PPOs) of medications in older adults. Researchers evaluated the prevalence and predictors of the cases of PPO in hospitalized patients and revealed that prescribing is highly prevalent among older hospitalized or community-dwelling patients and its impact on hospitalization (Abu Farha et al, 2018; Bo et al, 2018; Cardwell et al, 2020; Moriarty et al, 2016; Moriarty et al, 2020)
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