Análisis poblacional de la prescripción potencialmente inadecuada en ancianos según criterios STOPP/START (estudio STARTREC)()

OBJECTIVE: Rational prescribing in older people is a priority for health care organizations. The STOPP/START screening tool has been developed to identify potentially inappropriate prescribing (PIP) in individuals. In a primary care setting, STOPP/START can estimate PIP prevalence and related factors at population level. The aim of this study is to measure the prevalence rates of PPI in elderly population using clinical and prescription claim databases. DESIGN: Cross-sectional population study. SETTINGS: Primary Care, Lleida Health Region, Spain. PARTICIPANTS: 45.408 patients 70 years old and over, attended in the primary health care centers at least once the last year. METHODS: 43 STOPP and 12 START criteria are applied to their 2012 clinical and prescription records. Logistic regression models are adjusted to determine PIP association with several factors. RESULTS: 45,408 patients are included. The mean age is 79.7 years, 58% being female. The overall prevalence of PPI is 58.1%. According to STOPP, the most common drugs identified are benzodiazepines, non-steroidal anti-inflammatory drugs and proton pump inhibitors; according to START, osteoporosis treatments, antiplatelet agents, statins, metformin and beta blockers. PIP increases with age and polypharmacy and it is higher in long-term care facilities residents and patients receiving home health care. CONCLUSIONS: In our Health Region, at least 50% of the population aged 70 or older has one or more PIP, according to STOPP/START criteria.