Persistence of Effect of Medication Review on Potentially Inappropriate Prescriptions in Older Patients Following Hospital Discharge

Drugs Aging. 2021 Mar;38(3):243-252. doi: 10.1007/s40266-020-00830-6. Epub 2021 Jan 21.

Abstract

Background: Potentially inappropriate prescriptions (PIPs) can lead to adverse drug reactions and should be avoided whenever possible.

Objective: Our objective was to assess the PIP resumption rate 6 months after discharge from our geriatric unit and to compare it with data in the literature.

Methods: This single-center observational study included patients aged ≥ 70 years with at least one PIP that had been stopped during hospitalization (according to Screening Tool for Older Persons Prescriptions [STOPP] and Screening Tool to Alert doctors to Right Treatment [START] criteria, version 2) between May 2018 and October 2018. We collected sociodemographic data, medication reconciliation data, and descriptive data during a comprehensive geriatric assessment. Each patient's medication history after discharge was determined in collaboration with their usual community pharmacist.

Results: A total of 125 patients (females 70%, mean age 87.1 years) were included. Data for the admission and discharge medication reconciliations were available for 44 patients (35%). On admission, 121 of the 125 patients (97%) were taking cardiovascular medication. Of the 336 treatments withdrawn, 61 (18.2%) had been re-prescribed at 6 months post-discharge-including half within the first month. The most frequent STOPP criterion was lack of indication (32%), and the overall PIP resumption rate was 22%. According to the anatomical therapeutic chemical (ATC) classification, the main organ system affected by PIPs was the cardiovascular system (47%, with a resumption rate of 17%).

Conclusion: Our results highlighted a low PIP resumption rate at 6 months and showed that a collaborative medication review is associated with persistent medium-term medication changes.

Publication types

  • Observational Study

MeSH terms

  • Aftercare
  • Aged
  • Aged, 80 and over
  • Female
  • Hospitals
  • Humans
  • Inappropriate Prescribing* / prevention & control
  • Medication Reconciliation
  • Patient Discharge*