User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

Reduction of potentially inappropriate medications using the STOPP criteria in frail older inpatients: a randomised controlled study

Primary tabs

Dalleur, Olivia [UCL] Boland, Benoît [UCL] Losseau, Claire [UCL] Henrard, Séverine [UCL] Wouters, Dominique [UCL] Speybroeck, Niko [UCL] Degryse, Jean-Marie [UCL] Spinewine, Anne [UCL]

BACKGROUND: Hospital admissions may provide an opportunity to discontinue potentially inappropriate medications (PIMs) in older patients. Little is known about the effect of using the Screening Tool of Older People's potentially inappropriate Prescriptions (STOPP) in this context. This study aimed to test the hypothesis that specific STOPP recommendations from an inpatient geriatric consultation team (IGCT) to the hospital physician leads to reductions in PIMs for patients at discharge. METHODS: This was a randomised controlled study in 146 frail inpatients (in 2011). The intervention consisted of STOPP recommendations made by the IGCT to ward physicians to discontinue PIMs, in addition to the standard geriatric advice. RESULTS: Intervention (n = 74) and control (n = 72) groups were similar in terms of patient characteristics (median age 85 years; median number of daily drugs, seven) and PIM distribution (68 and 57 PIMs in 53 and 51 % of patients, respectively). At discharge, the reduction in PIMs was twice as high for the intervention group as for the control group (39.7 and 19.3 %, respectively; p = 0.013). The proportion of patients who still had one or more PIM at discharge did not differ between groups. In the 50 patients followed-up a year later, the majority of PIMs that had been stopped during hospitalisation had not been restarted after discharge (17/28; 61 %). The clinical relevance of PIMs identified at baseline in those patients was considered major (29 %), moderate (37 %), minor (5 %), deleterious (8 %), or not assessed (11 %). Discontinuation rate was not associated with clinical importance. CONCLUSION: Specific STOPP recommendations provided to hospital physicians doubled the reduction of PIMs at discharge in frail older inpatients. To further improve the appropriateness of prescribing in older patients, clinicians should focus on the STOPP criteria that are of major clinical importance, and general practitioners should be actively involved.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2014
Language Anglais
Journal information "Drugs & Aging" - Vol. 31, no. 4, p. 291-298 (2014)
Peer reviewed yes
Publisher Adis International Ltd. ((New Zealand) Auckland)
issn 1170-229X
e-issn 1179-1969
Publication status Publié
Affiliations UCL - SSS/IRSS - Institut de recherche santé et société
UCL - SSS/LDRI - Louvain Drug Research Institute
UCL - (SLuc) Service de gériatrie
UCL - (MGD) Département de pharmacie
UCL - (SLuc) Département de pharmacie
Links
  1. Hamilton Hilary J, Gallagher Paul F, O'Mahony Denis, Inappropriate prescribing and adverse drug events in older people, 10.1186/1471-2318-9-5
  2. Spinewine Anne, Schmader Kenneth E, Barber Nick, Hughes Carmel, Lapane Kate L, Swine Christian, Hanlon Joseph T, Appropriate prescribing in elderly people: how well can it be measured and optimised?, 10.1016/s0140-6736(07)61091-5
  3. Fialová Daniela, Potentially Inappropriate Medication Use Among Elderly Home Care Patients in Europe, 10.1001/jama.293.11.1348
  4. Hanlon Joseph T., Schmader Kenneth E., Ruby Christine M., Weinberger Morris, Suboptimal Prescribing in Older Inpatients and Outpatients, 10.1046/j.1532-5415.2001.49042.x
  5. Ryan C., O'Mahony D., Kennedy J., Weedle P., Cottrell E., Heffernan M., O'Mahony B., Byrne S., Potentially inappropriate prescribing in older residents in Irish nursing homes, 10.1093/ageing/afs068
  6. Page Robert L., Mark Ruscin J., The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use, 10.1016/j.amjopharm.2006.12.008
  7. Page RL 2nd, Linnebur SA, Bryant LL, et al. Inappropriate prescribing in the hospitalized elderly patient: defining the problem, evaluation tools, and possible solutions. Clin Interv Aging. 2010;5:75–87.
  8. Coleman Eric A., Smith Jodi D., Raha Devbani, Min Sung-joon, Posthospital Medication Discrepancies : Prevalence and Contributing Factors, 10.1001/archinte.165.16.1842
  9. Hajjar Emily R., Hanlon Joseph T., Sloane Richard J., Lindblad Catherine I., Pieper Carl F., Ruby Christine M., Branch Laurence C., Schmader Kenneth E., Unnecessary Drug Use in Frail Older People at Hospital Discharge : UNNECESSARY DRUG USE IN THE FRAIL ELDERLY AT HOSPITAL DISCHARGE, 10.1111/j.1532-5415.2005.53523.x
  10. Deschodt Mieke, Flamaing Johan, Rock Goele, Boland Benoit, Boonen Steven, Milisen Koen, Implementation of inpatient geriatric consultation teams and geriatric resource nurses in acute hospitals: A national survey study, 10.1016/j.ijnurstu.2011.11.015
  11. Rubenstein LZ, Stuck AE, Siu AL, et al. Impacts of geriatric evaluation and management programs on defined outcomes: overview of the evidence. J Am Geriatr Soc. 1991;39(9 Pt 2):8–16S (discussion 7–8S).
  12. Baeyens J.P., Belgian care programme for older patients, 10.1007/s12603-010-0034-9
  13. Deschodt Mieke, Flamaing Johan, Haentjens Patrick, Boonen Steven, Milisen Koen, Impact of geriatric consultation teams on clinical outcome in acute hospitals: a systematic review and meta-analysis, 10.1186/1741-7015-11-48
  14. Gallagher P., Ryan C., Byrne S., Kennedy J., O’Mahony D., STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation, 10.5414/cpp46072
  15. Gallagher Paul, Baeyens Jean-Pierre, Topinkova Eva, Madlova Pavla, Cherubini Antonio, Gasperini Beatrice, Cruz-Jentoft Alfonso, Montero Beatriz, Lang Pierre Olivier, Michel Jean-Pierre, O’Mahony Denis, Inter-rater reliability of STOPP (Screening Tool of Older Persons’ Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria amongst physicians in six European countries, 10.1093/ageing/afp058
  16. Hill-Taylor B., Sketris I., Hayden J., Byrne S., O'Sullivan D., Christie R., Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact, 10.1111/jcpt.12059
  17. Hamilton Hilary, Gallagher Paul, Ryan Cristin, Byrne Stephen, O’Mahony Denis, Potentially Inappropriate Medications Defined by STOPP Criteria and the Risk of Adverse Drug Events in Older Hospitalized Patients, 10.1001/archinternmed.2011.215
  18. Dalleur Olivia, Spinewine Anne, Henrard Séverine, Losseau Claire, Speybroeck Niko, Boland Benoit, Inappropriate Prescribing and Related Hospital Admissions in Frail Older Persons According to the STOPP and START Criteria, 10.1007/s40266-012-0016-1
  19. Gallagher Paul, Lang Pierre Olivier, Cherubini Antonio, Topinková Eva, Cruz-Jentoft Alfonso, Montero Errasquín Beatriz, Mádlová Pavla, Gasperini Beatrice, Baeyens Hilde, Baeyens Jean-Pierre, Michel Jean-Pierre, O’Mahony Denis, Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals, 10.1007/s00228-011-1061-0
  20. Gallagher P., O'Mahony D., STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria, 10.1093/ageing/afn197
  21. Gallagher P F, O'Connor M N, O'Mahony D, Prevention of Potentially Inappropriate Prescribing for Elderly Patients: A Randomized Controlled Trial Using STOPP/START Criteria, 10.1038/clpt.2011.44
  22. McCusker Jane, Bellavance Francois, Cardin Sylvie, Trepanier Sylvain, Verdon Josee, Ardman Orly, Detection of Older People at Increased Risk of Adverse Health Outcomes After an Emergency Visit: The ISAR Screening Tool, 10.1111/j.1532-5415.1999.tb05204.x
  23. Folstein Marshal F., Folstein Susan E., McHugh Paul R., “Mini-mental state”, 10.1016/0022-3956(75)90026-6
  24. Katz Sidney, Studies of Illness in the Aged : The Index of ADL: A Standardized Measure of Biological and Psychosocial Function, 10.1001/jama.1963.03060120024016
  25. Moher D., Hopewell S., Schulz K. F, Montori V., Gotzsche P. C, Devereaux P J, Elbourne D., Egger M., Altman D. G, CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials, 10.1136/bmj.c869
  26. Nakash Rachel A, Hutton Jane L, Jørstad-Stein Ellen C, Gates Simon, Lamb Sarah E, Maximising response to postal questionnaires – A systematic review of randomised trials in health research, 10.1186/1471-2288-6-5
  27. Spinewine Anne, Dhillon Soraya, Mallet Louise, Tulkens Paul M, Wilmotte Léon, Swine Christian, Implementation of Ward-Based Clinical Pharmacy Services in Belgium—Description of the Impact on a Geriatric Unit, 10.1345/aph.1g515
  28. Hogan DB, Fox RA, Badley BW, et al. Effect of a geriatric consultation service on management of patients in an acute care hospital. CMAJ. 1987;136(7):713–7.
  29. McVey Laura J., Effect of a Geriatric Consultation Team on Functional Status of Elderly Hospitalized Patients : A Randomized, Controlled Clinical Trial, 10.7326/0003-4819-110-1-79
  30. Pyszka Lauren L., Seys Ranola Trisha M., Milhans Sara M., Identification of Inappropriate Prescribing in Geriatrics at a Veterans Affairs Hospital Using STOPP/START Screening Tools, 10.4140/tcp.n.2010.365
  31. Hanlon Joseph T., Schmader Kenneth E., Samsa Gregory P., Weinberger Morris, Uttech Kay M., Lewis Ingrid K., Cohen Harvey Jay, Feussner John R., A method for assessing drug therapy appropriateness☆, 10.1016/0895-4356(92)90144-c
  32. Ryan Cristín, O’Mahony Denis, O’Donovan Dónal Óg, O’Grady Emer, Weedle Peter, Kennedy Julia, Byrne Stephen, A comparison of the application of STOPP/START to patients’ drug lists with and without clinical information, 10.1007/s11096-012-9733-0
  33. Spinewine Anne, Swine Christian, Dhillon Soraya, Lambert Philippe, Nachega Jean B., Wilmotte Léon, Tulkens Paul M., Effect of a Collaborative Approach on the Quality of Prescribing for Geriatric Inpatients: A Randomized, Controlled Trial : IMPROVING QUALITY OF DRUG USE IN ELDERLY INPATIENTS, 10.1111/j.1532-5415.2007.01132.x
  34. Gillespie Ulrika, Alassaad Anna, Hammarlund-Udenaes Margareta, Mörlin Claes, Henrohn Dan, Bertilsson Maria, Melhus Håkan, Effects of Pharmacists' Interventions on Appropriateness of Prescribing and Evaluation of the Instruments' (MAI, STOPP and STARTs') Ability to Predict Hospitalization–Analyses from a Randomized Controlled Trial, 10.1371/journal.pone.0062401
  35. Barry P. J., Gallagher P., Ryan C., O'mahony D., START (screening tool to alert doctors to the right treatment) an evidence-based screening tool to detect prescribing omissions in elderly patients, 10.1093/ageing/afm118
Bibliographic reference Dalleur, Olivia ; Boland, Benoît ; Losseau, Claire ; Henrard, Séverine ; Wouters, Dominique ; et. al. Reduction of potentially inappropriate medications using the STOPP criteria in frail older inpatients: a randomised controlled study. In: Drugs & Aging, Vol. 31, no. 4, p. 291-298 (2014)
Permanent URL http://hdl.handle.net/2078.1/140775