Polypharmacy: yet more proof for RX deprescribing potential
In the publication 'Medication review versus usual care to improve drug therapies in hospitalised older patients admitted to internal medicine wards', researchers Marialuisa Aiezza, Alessandro Bresciani, Gaspare Guglielmi, Marida Massa, Elena Tortori, Raffaele Marfella, Emilio Aliberti, Arcangelo Iannuzzi deliver yet more significant proof of the true potential of RX review and deprescribing.
They conclude that the correct application of the BEERS, START and STOPP criteria decreased IPs by 38% and reduced the number of drugs prescribed by the physician during the stay in the medical ward and at discharge by 19%.
From the abstract: "Older adults are a vulnerable and growing segment of the population with a high burden of comorbid conditions. As a consequence of increased co-morbidity, drug use in older adults is high, and polypharmacy has been linked to higher risk of adverse drug–drug interactions, morbidity, and mortality. The aim of the study was to evaluate the prevalence and nature of potentially inappropriate medications (PIMs) in a group of hospitalised older patients, and verify whether the use of ‘Beers criteria’ and/or ‘START & STOPP’ criteria could lead to deprescribing of drugs and reduce the length of stay in the hospital.
Two hundred acutely ill patients aged ≥65 with multimorbidity admitted to the Division of Internal Medicine were enrolled in the study. Enrolled patients were admitted as medical emergencies and observed during their hospitalisation at the Emergency Department and subsequently at the Division of Internal Medicine. The pharmacological treatments taken by patients at home, during hospitalisation and at discharge, were examined, identifying inappropriate prescriptions (IPs), according to ‘Beers criteria’ and ‘START and STOPP’ criteria."
Automated means of applying such criteria are available and help professionals execute these elaborate tasks more rapidly and precisely.