SUMMARY
Objective: The goals of this study are to determine the prevalence of polypharmacy in elderly nursing home patients treated at emergency departments (ED) in Madrid, potentially inappropriate medication (PIM) and examine if this contributes to the emergency visit.
Design: A cohort of 124 nursing home residents, aged 75 and older, were recruited in this cross-sectional study during the month of July, in 2012. We used STOPP/START (Screening Tool of Older Person’s Prescriptions/Screening Tool to Alert to Right Treatment) criteria as a screening tool for assessing the appropriateness of medications in this group of patients.
Results: On average patients were taking nine different medications. In this study 101 patients (81,5%) had at least one STOPP criterion, with an average of 2 criteria per patient, and 104 (83,9%) patients were not receiving at least one drug indicated for their illness (START criterion). In 16% of visits one of the reasons for admission was due to adverse events caused by medications considered to be potentially inappropriate. Recent hospital visits, in the prior 6 months, do not improve medication appropriateness.
Conclusion: PIM is a highly prevalent problem among nursing home residents, and a statistically significant positive correlation was found between PIM and cause of admission in the emergency room. Vigilant ED drug supervision is essential in this group of patients. The National Health Service should develop routine medication reviews in elderly nursing home residents.
Key Words: Inappropriate prescription, nursing homes, elderly, emergency room.
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Correspondencia:
Cristina Bermejo Boixareu / Virginia Saavedra Quirós
Hospital Universitario Puerta de Hierro Majadahonda (Servicio de Urgencias)
C/ Manuel de Falla, 1 / C/ Joaquín Rodrigo, 2
28222 Majadahonda (Madrid)
Correo electrónico: virginia.saavedra@salud.madrid.org / cristina_bermejo@hotmail.com
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Bermejo Boixareu C1,3, Saavedra Quirós V2, Gutiérrez Parres B1,4, Núñez González A1, Cerezo Olmos C1,4,
Sánchez Guerrero A2, Gómez Rodrigo J1
1 Adjunto de Servicio de Urgencias Hospital Universitario Puerta de Hierro Majadahonda. Madrid (España)
2 Adjunto de Servicio de Farmacia. Hospital Universitario Puerta de Hierro Majadahonda. Madrid (España)
3 Profesor Medicina en la Universidad Alfonso X El Sabio. Madrid (España)
4 Profesor en la Universidad Europea de Madrid (España)
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Rev. O.F.I.L. 2016, 26;1
Fecha de recepción: 28/04/2015 – Fecha de aceptación: 21/10/2015
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Article in number: VOL. 26 – Nº1 – 2016