Evaluation of Inappropriate Prescribing in Patients Older than 65 Years in Primary Health Care

J Clin Med. 2019 Mar 4;8(3):305. doi: 10.3390/jcm8030305.

Abstract

To asses inappropriate prescribing and its predisposing factors in polymedicated patients over the age of 65 in primary health care.

Design: cross-sectional study.

Setting: Primary care centres in the Costa del Sol Health District and Northern Health Area of Malaga in southern Spain.

Participants: Patients older than 65 years who use multiple medications. Data collection was conducted during 1 year in a population of 425 individuals who comprised a stratified randomized sample of the population of health care users in the study area. The data were collected by interview on a structured data collection form.

Study variables: Dependent variable: Potentially inappropriate prescribing (PIP) (STOPP/START criteria). Predictor variables: Sociodemographic characteristics, clinical characteristics and medication use. A descriptive analysis of the variables was performed. Statistical inference was based on bivariate analysis (Student's t or Mann-Whitney U test and chi-squared test) and multivariate analysis was used to control for confounding factors. 73.6% of participants met one or more STOPP/START criteria. According to information about prescribed treatments, 48.5% of participants met at least one STOPP criterion and 43.30% of them met at least one START criterion. The largest percentage of inappropriate prescriptions was associated with cardiovascular treatments. More than three-quarters of the participants had one or more inappropriate prescriptions for medicines in primary care, according to STOPP/START criteria. In addition, PIP was directly related to the number of prescribed medications, gender and specific pathologies (diabetes).

Keywords: elderly; inappropriate prescribing; patient safety; polymedicated; primary care; risk factors STOPP/START.