Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities.

Détails

ID Serval
serval:BIB_66E66896EB17
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities.
Périodique
Age and Ageing
Auteur(s)
Lang P.O., Hasso Y., Dramé M., Vogt-Ferrier N., Prudent M., Gold G., Michel J.P.
ISSN
1468-2834 (Electronic)
ISSN-L
0002-0729
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
39
Numéro
3
Pages
373-381
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
OBJECTIVE: the study aimed to determine the prevalence of and risk factors for inappropriate prescribing (IP) and prescribing omission (PO) in elderly with mental co-morbidities.
PARTICIPANTS: One hundred fifty consecutive inpatients with mental co-morbidities hospitalised for acute medical illness (mean age 80 +/- 9, 70% of women) were considered for the study.
MEASUREMENTS: IP and PO were prospectively identified according to STOPP/START criteria at hospital admission.
RESULTS: over 95% were taking >or=1 medication (median = 7) which amounted to 1,137 prescriptions. The prevalence of IP was 77% and PO was 65%. The most frequent encountered IP concerned drugs adversely affecting fallers (25%) and antiaggregants therapy without atherosclerosis (14%). PO concerned antidepressants with moderate/severe depression (20%) and calcium-vitamin D supplementation (18%). Independent predictors for IP were increased number of concomitant drugs (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.13-1.89), being cognitively impaired (OR 1.83, 95% CI 1.55-2.24), and having fallen in the preceding 3 months (OR 2.03, 95% CI 1.52-2.61) or hospitalised in the preceding year (OR 1.09, 95% CI 1.02-1.23). Concerning PO, psychiatric disorder (OR 1.64, 95% CI 1.42-2.01) and increase level of co-morbidities (OR 1.79, 95% CI 1.48-1.99) were identified. Living in an institutional setting was a predictive maker for both IP (OR 1.45, 95% CI 1.27-1.74) and PO (OR 1.67, 95% CI 1.32-1.91).
CONCLUSION: IP and PO were highly prevalent raising the need of a greater health literacy concerning geriatric conditions in non-geriatrician practitioners who care elderly as well as in the community, in hospital and institutional settings for improving quality and safety in prescribing medication.
Mots-clé
Aged, Aged, 80 and over, Comorbidity, Drug Prescriptions/standards, Drug Prescriptions/statistics & numerical data, Female, Humans, Inpatients, Male, Medication Errors/statistics & numerical data, Mental Disorders/drug therapy, Physician's Practice Patterns/standards, Physician's Practice Patterns/statistics & numerical data, Prevalence, Prospective Studies, Psychotropic Drugs/therapeutic use, Risk Factors
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/04/2015 9:27
Dernière modification de la notice
20/08/2019 15:22
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