Potentially inappropriate prescribing according to STOPP-2 criteria among elderly patients in an acute medical department: An observational study of prevalence, predictive factors

Abstract

The aim of the study was to assess the prevalence and factors associated with potentially inappropriate medication use in elderly patients hospitalized in an acute medical unit. It is a prospective observational study carried out in the acute medical unit of Ibn Sina University Hospital located in Rabat, Morocco. The study sample consisted of all hospitalized patients aged ≥65years. Data collection was performed by a clinical pharmacist during an interview with the patient, at the multidisciplinary team meeting and from the patient's medical records. Medication use was assessed everyday from admission to discharge. The frequency of potentially inappropriate medication (PIM) was evaluated using The Screening Tool of Older Person's Prescriptions (STOPP) criteria version 2. The study involved 123 elderly inpatients aged 75±7 years old. In total, 55 patients (44.7%) used≥1 PIM. The highest prevalence of PIMs was in relation with concomitant use of two or more drugs with anticholinergic properties (16%). In adjusted multivariate analysis, the following parameters were independently associated with PIM use: length of stay at the acute medical unit (OR 1.12; 95% CI 1.00-1.20), and number of pre-admission drugs (OR 1.30; 95% CI 1.00-1.60). Half of the elderly population received at least one PIM identified by the STOPP criteria. Inadequacy of prescription was associated with the number of pre-admission drugs and the length of stay. Assessing medication during conciliation and enhanced drugs monitoring at discharge especially for patients with a longer stay can be an important strategy for minimizing PIM use.