Abstract
Background: Elderly people have multiple comorbidities that often require treatment
with multiple medications. Having strategies to lessen the risks associated with pharmacological
interactions and potentially inadequate prescribing (PIP) is of major importance. The STOPP–
START criteria are useful in identifying PIP along with other tools, such as LASA (look
alike/sound alike) drugs and high-risk medications (HRM).
Objective: We aimed to clinically and sociodemographically characterize the population with
PIP according to the STOPP–START criteria in hospitalized elderly patients over 6 months in a
third-level hospital in Colombia, South America. We also aimed to calculate the prevalence of
PIP, LASA drugs and HRM and to identify other problems related with medication. Finally, we
proposed an algorithm for the identification of PIP in this population.
Methods and Materials: This was a descriptive, cross-sectional study in hospitalized patients
older than 60 years during the first semester of 2021 to identify PIP according to STOPP–
START criteria. An analysis of clinical and sociodemographic variables was conducted, as well
as the construction of an algorithm to identify PIP in the elderly in a semiautomated way. Data
were collected and analyzed using the software SPSS 2021, using descriptive statistics and
measures of central tendency.
Results: The prevalence of PIP in the study population was 25%. Furthermore, 60% of patients
had one problem related to medication, and 27% used at least one LASA drug or HRM.
Conclusion: This study allows one to characterize, for the first time, the Colombian population
prone to PIP, as well as the construction of an algorithm that identifies PIP in a semiautomated
way.
Keywords:
STOPP–START, prescription, pharmacotherapy, LASA, medicines reconciliation, HRM.
Graphical Abstract
[5]
Gallo A, Vilosio JO, Saimovici J. Update of the STOPP-START criteria: A tool for the detection of potentially inappropriate medication in the elderly. Evid Update Ambulat Pract 2016; 18(4): 1-6.
[17]
Filik R, Purdy K, Gale A, Gerrett D. Drug name confusion: Evaluating the effectiveness of capital ("Tall Man") letters using eye movement data. Soc sci med 2004; 59(12): 2597-601.
[19]
Cohen MR, Smetzer JL, Tuohy NR, Kilo CM. High-Alert Medications: Safeguarding against Errors 2nd Ed;. American Pharmacist Association 2007.
[22]
Grupo de Investigación en Atención Farmacéutica (Universidad de Granada). Third Granada consensus on medication-related problems (PRM) and negative outcomes associated with medication (RNM). Ars Pharm 2007; 48(1): 5-17.
[23]
University of La Sabana Clinic. Instructions for the correct labeling of medications and medical devices 2023.
[26]
Rivera Plaza L. Inappropriate drug prescription and its relationship with therapeutic compliance in polymedicated patients. Gerokomos 2018; 29: 123-7.
[30]
Álpizar Cortes JE, Angeles Lozano KL, Ávila Ballesteros D, et al. Identification of potential drug interactions in geriatric patients. J Negat No Posit Resul 2020; 5: 998-1009.
[31]
Lizarazo J, Daza D, Parrado Y. Pharmacotherapy follow-up as a tool for minimization of risk derivated from negative outcomes related to medication in elderly patients. Bogotá-Colombia Tercer Congreso Colombiano de Atención Farmacéutica.
[34]
García Orihuela M, Suárez Martínez R, Pérez Hernández B. STOPP-START criteria and inappropriate prescription for the elderly. Rev Habanera Cienc Méd 2020; 19.
[35]
Mud F, Mud S, Rodriguez MJ, Ivorra MD, Ferrandiz ML. Detection of potentially inappropriate prescriptions in elderly patients: descriptive study in two community pharmacies. Farm Com 2014; 6(2): 20-6.