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Medication Evaluation in Portuguese Elderly Patients According to Beers, STOPP/START Criteria and EU(7)-PIM List – An Exploratory Study

Authors Monteiro C, Canário C, Ribeiro MÂ, Duarte AP, Alves G

Received 23 January 2020

Accepted for publication 21 March 2020

Published 5 May 2020 Volume 2020:14 Pages 795—802


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Cristina Monteiro,1 Catarina Canário,2,3 Manuel Ângelo Ribeiro,3 Ana Paula Duarte,1,2 Gilberto Alves1,2

1UFBI – Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; 2CICS-UBI – Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal; 3Associação de Socorros Mútuos-Mutualista Covilhanense, Covilhã, Portugal

Correspondence: Cristina Monteiro
UFBI – Pharmacovigilance Unit of Beira Interior, Faculty of Health Sciences, University of Beira Interior, Covilhã 6200-506, Portugal
Tel +35 1275329070

Purpose: The increase in drug prescription for the elderly raises the risk of the occurrence of potentially inappropriate medications (PIMs), thus increasing the incidence of drug-related problems. Likewise, potential prescribing omissions (PPOs) are also highly prevalent in the elderly. This study aimed at assessing the prevalence of PIMs in the elderly by using the EU(7)-PIM list, STOPP criteria version 2 and the Beers criteria version 2015, as well as the prevalence of PPOs by applying the START criteria version 2 in elderly nursing home residents and outpatients of the Eastern Central Region of Portugal.
Patients and Methods: A descriptive cross-sectional study was carried out in a sample of 90 Portuguese elderly people. Age, gender, diagnoses and medication history were collected from the patients’ clinical records. The prevalence of PIMs and PPOs was measured according to each of the criteria applied.
Results: The patients’ ages ranged from 65 to 103 years, with an average age of 84.15 years. In addition, the average number of medications prescribed was 7.6. The STOPP criteria identified 250 PIMs affecting 77 patients (85.5%), the EU(7)-PIM list detected 94 PIMs in 58 patients (64.4%) and the Beers criteria identified 69 PIMs in 51 patients (56.6%). Therefore, the STOPP criteria version 2 identified substantially more PIMs than the other two tools. Furthermore, by applying the START criteria 68 PPOs were detected in 52 patients (57.7%).
Conclusion: A high prevalence of PIMs and PPOs was observed, suggesting the need to implement actions aimed at reducing the phenomenon and thus help to improve the quality of care provided in nursing homes. The variations in prevalence with the different tools suggest the need to carefully choose the tool for medication review in the elderly.

Keywords: potentially inappropriate medications, potential prescribing omissions, EU(7)-PIM list, STOPP/START criteria version 2, Beers criteria version 2015, elderly

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