Evaluation and assessment of prescribing patterns in elderly patients using two explicit criteria based screening tools: (The PRISCUS list and STOPP/START criteria)

Irum Butool; Shabnam Nazir; Maryam Afridi; Syed Majid Shah

doi:10.12669/pjms.346.14928

Evaluation and assessment of prescribing patterns in elderly patients using two explicit criteria based screening tools: (The PRISCUS list and STOPP/START criteria)

Pak J Med Sci. 2018 Nov-Dec;34(6):1357-1362. doi: 10.12669/pjms.346.14928.

Authors

Irum Butool¹, Shabnam Nazir², Maryam Afridi³, Syed Majid Shah⁴

Affiliations

¹ Irum Butool, Department of Pharmacy, Kohat University of science and Technology, Kohat, Pakistan.
² Shabnam Nazir, Assistant Professor, Department of Pharmacy, Kohat University of science and Technology, Kohat, Pakistan.
³ Maryam Afridi, Department of Pharmacy, Kohat University of science and Technology, Kohat, Pakistan.
⁴ Syed Majid Shah, Department of Pharmacy, Kohat University of science and Technology, Kohat, Pakistan.

Abstract

Background & objectives: Rational prescribing can prevent medication errors and the associated harm, especially in old age patients, as they are being frequently prescribed with drugs for various ailments. Moreover, polypharmacy is a common practice in them. Therefore, a significant threat of potential drug interactions and adverse effects exist. Current study focuses on assessment of Potentially Inappropriate Medication (PIM) in medication prescribed to old age patients.

Methods: It was a forty days, descriptive and observational study conducted from August 15^th 2017 to September 25^th 2017 in which prescriptions given to elderly patients were reimbursed for collecting various sets of information. In order to assess PIMs (in Pakistani Set-up), STOPP/START addition 2008 (including examples of misprescribing, overprescribing and under prescribing) and the PRISCUS list (misprescribing and overprescribing) was used. Statistical analysis of results was performed using SPSS version 20.

Results: One hundred forty six cases of PIMs (including incorrect prescribing, overprescribing and under prescribing) were detected. It included incorrect prescriptions 104, under prescription 28 and over prescriptions 14. NSAIDS accounted for most incorrect prescriptions followed by benzodiazepines. Mostly NSAIDS were used for myalgia, backache and rheumatoid disorders.

Conclusion: Current findings highlighted Potentially Inappropriate Prescribing (PIP), particularly of NSAIDs and under prescribing of statins in cardiovascular diseases. Study findings suggest introducing pertinent interventions at the stages involved in prescribing, prescription review and its follow up to reduce the PIP and PIMs.

Keywords: Ambulatory elderly; PRISCUS list; Potential prescribing omissions; Potentially inappropriate medication; STOPP/START criteria.