Potentially inappropriate prescribing in Ethiopian geriatric patients hospitalized with cardiovascular disorders using START/STOPP criteria

Abstract

BackgroundThere was a paucity of data on the magnitude of potentially inappropriate prescriptions (PIPs) among Ethiopian elderly cardiovascular patients.ObjectiveThe aim of this study was to assess PIPs and associated factors in the elderly population with cardiovascular disorders using the START/STOPP screening criteria.MethodsA hospital-based cross-sectional study was conducted at medical wards of a teaching hospital in Ethiopia from 1 December 2016–30 May 2017. Included patients were hospitalized elderly patients aged 65 years or older with cardiovascular disorders; their medications were evaluated using the START/STOPP screening criteria from admission to discharge. Multivariable logistic regression was applied to identify factors associated with inappropriate medications. One Way Analysis Of Variance (ANOVA) was carried out to test significant differences on the number of PIPs per individual diagnosis.ResultsTwo hundred thirty-nine patients were included in the analysis. More-than a third of the patients were diagnosed with heart failure, 88 (36.82%). A total of 221 PIPs were identified in 147 patients, resulting in PIP prevalence of 61.5% in the elderly population. Of the total number of PIPs, occurrence of one, two and three PIPs accounted for 83 (56.4%), 52(35.4%), and 12(8.2%) respectively. One way ANOVA test showed significant differences on the mean number of PIPs per individual diagnosis (f = 5.718, p<0.001). Angiotensin Converting Enzyme Inhibitors (ACEIs) were the most common inappropriately prescribed medications, 32(14.5%). Hospital stay, AOR: 1.086 (1.016–1.160), number of medications at discharge, AOR: 1.924 (1.217–3.041) and the presence of co-morbidities, AOR: 3.127 (1.706–5.733) increased the likelihood of PIP.ConclusionApproximately, two-thirds of elderly cardiovascular patients encountered potentially inappropriate prescriptions. ACEIs were the most commonly mis-prescribed medications. Longer hospital stay, presence of comorbidities and prescription of large number of medications at discharge have been correlated with the occurrence of inappropriate medication. It is essential to evaluate patients’ medications during hospital stay using the STOPP and START tool to reduce PIPs.

Appropriateness of Medication Prescribing in Hospitalized Older Adults in a Tertiary Teaching Hospital in the Philippines: A Cross-Sectional Study

“…PIM rates of 41.5% and 42.1% were reported in patients admitted to the medical department of a hospital in Spain [ 12 ] and to the Medical and Surgical Departments of a university hospital in Japan [ 26 ], respectively. The reported prevalences of PIMs in hospitalized older adults using the same version were higher in patients admitted to specialty wards of a tertiary hospital in Brazil (50%) [ 27 ], patients discharged from a geriatric teaching hospital in Belgium (56%) [ 28 ], patients discharged from a medical unit in the UK (59.1%) [ 29 ], cardiovascular patients admitted to a teaching hospital in Ethiopia (61.5%) [ 30 ], patients discharged from the cardiology and medicine departments of a university hospital in Albania (63%) [ 31 ], and patients requiring palliative care in a geriatric acute care hospital in Spain (88.5%) [ 32 ]. The timing of data collection (at admission or discharge), the units to which patients were admitted, and patient characteristics may have accounted for the discrepancies in PIM prevalence.…”

Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer’s Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan

“…The prescribing practices of potentially inappropriate medications (PIMs), especially when better and effective drugs are available, refer to the use of such medicines whose risk may outweigh the beneficial therapeutic outcomes. The prescribing of these medications can be termed as potentially inappropriate prescribing (PIP) [ 11 ]. The utilization of PIMs by the older patients is common globally.…”

Potentially inappropriate medication use among elderly patients on follow-up at the chronic care clinic of a specialized teaching hospital in Ethiopia. A cross-sectional study

“…This indicates nearly half of our participants were taking medication which could be harmful to their health. Using the same criteria, studies from Gondar (23) and Kuwait (18) reported at least one PIMU in 61.5% and 55.7% of elderly out patients, respectively. These magnitudes are higher than our study nding.…”