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Potentially Inappropriate Prescriptions in Ambulatory Elderly Patients Living in Rural Areas of Romania Using STOPP/START (Version 2) Criteria

Authors Buda V, Prelipcean A, Andor M, Dehelean L, Dalleur O, Buda S, Spatar L, Mabda MC, Suciu M, Danciu C, Tudor A, Petrescu L, Cristescu C

Received 3 October 2019

Accepted for publication 29 January 2020

Published 19 March 2020 Volume 2020:15 Pages 407—417

DOI https://doi.org/10.2147/CIA.S233270

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker


Valentina Buda,1,* Andreea Prelipcean,2,* Minodora Andor,3,* Liana Dehelean,4,* Olivia Dalleur,5 Simona Buda,2 Lavinia Spatar,2 Maria Cristiana Mabda,1 Maria Suciu,1 Corina Danciu,6 Anca Tudor,7 Lucian Petrescu,8,9 Carmen Cristescu1

1Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 2“Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 3Department of Medical Semiotics, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 4Discipline of Psychiatry, Department of Neurosciences, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 5Clinical Pharmacy Research Group, Louvain Drug Research Institute, Université catholique de Louvain UCLouvain, Bruxelles, Belgium; 6Department of Pharmacognosy, Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 7Department of Statistics and Biomedical Informatics, Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 8Department of Cardiology VI, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania; 9Cardiovascular Diseases Institute, Timisoara, Romania

*These authors contributed equally to this work

Correspondence: Valentina Buda
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, “Victor Babeş” University of Medicine and Pharmacy, 2 Eftimie Murgu Street, Timisoara 300041, Romania
Tel/Fax +40-256-494-604
Email buda.valentina.oana@gmail.com

Background: Rational use of medications and monitoring of prescriptions in elderly patients is important to decrease the number and duration of hospitalizations, emergency medical consultations, mortality, as well as medical costs.
Purpose: To identify potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs), and determine their prevalence based on the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) v2 criteria and Screening Tool to Alert doctors to Right Treatment (START) v2 criteria for patients aged > 65 years.
Methods: This cross-sectional study was conducted in two rural counties in Romania based on electronic prescriptions for chronic conditions (EPCCs) issued from 30 days to 90 days by a specialist or general practitioner. Collected EPCCs were evaluated by an interdisciplinary team of specialists based on 26 STOPP v2 criteria and 10 START v2 criteria.
Results: PIM prevalence was 25.80% and PPO prevalence was 41.72% for 646 EPCCs. The mean age of patients was 75 years and the mean number of drugs per EPCC was four. The most frequently identified PIMs were treatment duration (6.65%), theophylline administration (5.72%), drug indication (4.64%), cyclo-oxygenase-2 non-steroidal anti-inflammatory drugs (1.39%), and zopiclone prescription (0.77%). Statins (24.76%), beta-blockers (8.04%), and beta-2 agonist/antimuscarinic bronchodilators (5.88%) were the most frequently identified PPOs.
Conclusion: PPOs were more prevalent than PIMs for elderly populations living in the two rural counties in Romania we studied. Health practitioners (family physicians, specialists, and pharmacists) should focus on prophylactic and curative considerations when prescribing agents to decrease the morbidity and mortality of elderly rural Romanian patients.

Keywords: Romanian elderly, rural zones, chronic prescriptions, STOPP, START


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