Prescripción potencialmente inapropiada en mayores de 65 años en un centro de salud de atención primaria()

OBJECTIVE: To identify potentially inappropriate prescriptions (PPI) and prescribing omissions (OP) by means of the STOPP/START criteria, as well as associated factors in ≥ 65 year old patients in a Primary Care setting in Spain. STUDY DESIGN: A cross-sectional, descriptive study. SETTING: Centro de Salud Monóvar, Primary Health Care. Study period: 6 months. PATIENTS RANDOM SAMPLE: 247 patients. Eligibility criteria: ≥ 65 years patients who attended an urban Primary Care clinic 2 or more times were studied. Terminally ill and nursing home residents were excluded. METHODS: Data were collected from electronic clinical records. STOPP and START criteria were evaluated in each clinical record, including age, sex, co-morbidity, number of chronic prescriptions. Main outcomes: PPI and OP identified by STOPP and START criteria, respectively. RESULTS: A total of 81 patients (32.8%) had PPI, with the most common being the long-term use of long-acting benzodiazepines in 17 (6.9%). OP was found in 73 (29.6%) patients, with the most common being the omission of statins in patients diagnosed with diabetes mellitus and/or one or more major cardiovascular risk factors in 21 (8.5%). After adjustment by gender and age, correlations were found between PPI and multiple medication (OR: 2.02; 95% CI: 1.15-3.53; P = .014), and OP and polypharmacy (OR: 2.37; 95% CI: 1.32-4.24; P = 0.004). CONCLUSIONS: Inappropriate prescribing in older people is frequent, and is mainly associated with long-acting benzodiazepines. There are diabetic patients who do not have statins prescribed. Multiple medication is associated with PPI and OP.