Prescribing for the Elderly
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Prescribing for the Elderly
05.01.2010

Ageing is associated with increasing numbers of medical problems that usually require drug therapy. This common scenario is associated with polypharmacy, i.e. the use of multiple medicines, which in turn is strongly linked to increased risk of adverse side-effects.
In addition, other medical conditions that the patient may have can mean that certain drugs are best avoided.

Researchers from the UCC Schools of Pharmacy and Medicine have recently published their findings from a study of the application of STOPP/START criteria in over 1300 older people, with an average age of 75 years, living in the community. STOPP (Screening Tool of Older Persons’ Prescriptions) is an evidence-based list of instances of potentially inappropriate medications in older people; START (Screening Tool to Alert to Right Treatment) is a list of potential errors of medication omission in older people. These criteria have been validated and published.

The findings appeared in the December 2009 issue of the British Journal of Clinical Pharmacology. Using STOPP criteria, 21% of older people studied were taking one or more potentially inappropriate medicines; using START criteria, 23% were not prescribed one or more potentially beneficial medicines. This is a similar rate to that reported in the UK (25%) in a recent study. The rate of potentially inappropriate medication prescription in older primary care patients across Europe reported from other published studies varies from 10% to 38%.

Potentially inappropriate medication prescription is a Europe-wide phenomenon. The UCC group is now embarking on further research to examine whether routine application of STOPP/START criteria at the point of prescription initiation and renewal can help reduce the rate of potentially inappropriate prescriptions in older people, minimise drug adverse side-effects and reduce avoidable drug expenditure.

Picture:  School of Pharmacy, UCC

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