STOPP START

AIMS: Evidence suggests that a high-dose statin loading before a percutaneous coronary revascularization improves outcomes in patients receiving long-term statins. This study aimed to analyse the effects of such an additional statin therapy before surgical revascularization. METHODS AND RESULTS: This investigator-initiated, randomized, double-blind, and placebo-controlled trial was conducted from November 2012 to April 2019 at 14 centres in Germany. Adult patients (n = 2635) with a long-term statin treatment (≥30 days) who were scheduled for isolated coronary artery bypass grafting (CABG) were randomly assigned to receive a statin-loading therapy or placebo at 12 and 2 h prior to surgery using a web-based system...

BACKGROUND: Atrial Fibrillation (AF) is common in the elderly. A key component of AF management is Oral Anticoagulant Therapy (OAT), consisting of Vitamin K Antagonists (VKAs) or Direct Oral Anticoagulants (DOACs). The aim of the present study is to check, using STOPP (Screening Tool of Older Persons' Prescriptions)/START (Screening Tool to Alert to Right Treatment) Criteria, if such drugs are potentially inappropriately prescribed/omitted in an elderly population with AF, and to determine their impact on mortality...

BACKGROUND: There is a scarcity of research in applying the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) criteria to older adults admitted to a psychiatric hospital. OBJECTIVES: The primary aim of this study was to determine the extent of polypharmacy in older adults admitted to a psychiatric hospital and to assess the number of STOPP/START triggers detected and recommended by pharmacists. Secondary objectives include evaluating if the STOPP/START criteria is a useful tool to improve prescribing in this setting by assessing the implementation rates of STOPP/START triggers...

INTRODUCTION: Inappropriate prescribing is a major problem in psychiatric care in older adults. Factors such as the high proportion of older people with a high prevalence of mental disorders, the physiological changes typical of aging, multimorbidity, polypharmacy, the lack of evidence in treatment guidelines for this population, the degree of professional ignorance; give rise to the propensity to make prescription errors of various kinds. OBJECTIVE: To review and summarize the available prescription tools that can provide support to improve prescription practices in psychopharmacology of the elderly...

OBJECTIVE: To assess the pharmacist's contributions by analysing potentially inappropriate prescription and home treatment reconciliation in the complex chronic patient unit of a tertiary hospital. METHOD: Observational, prospective, multidisciplinary study of patients in the complex chronic patient unit of a hospital during February 2019 - June 2020. Multidisciplinary team of the complex chronic developed a checklist with a selection of non-recommended drugs based on STOPP/START, Beers and PRISCUS criteria, and drugs susceptible to deprescription according to LESS-CHRON criteria...

OBJECTIVES: Drug-related problems (DRPs) are a well-known cause of emergency department (ED) visits. The objective of the FARM-URG project was to assess the prevalence of DRPs using an annual cross-sectional registry. Herein we report results of the first 3 years, indicating the prevalence of DRPs, drugs involved, and patient characteristics. METHODS: A point-prevalence multicenter study was conducted across EDs of hospitals in Spain. A specified day and hour was assigned to collect data from all adult patients attending the ED due to DRPs during three consecutive years...

BACKGROUND: Polypharmacy and inappropriate prescribing are risk factors for adverse clinical outcomes in older people. Screening tools can identify potential medicine-related patient safety incidents for the elderly on multiple medicines and with chronic diseases. METHODS: In this prospective observational study, details of demography, diagnosis, history of constipation/peptic ulcer disease, over-the-counter medications, and clinical and laboratory findings were noted...

Antiretroviral therapy (ART) has modified the prognosis of HIV which has evolved into a chronic condition. People living with HIV (PLWH) are living longer presenting an increased number of comorbidities leading to polypharmacy. Literature on the prevalence, associated factors, drug-drug interactions (DDIs), effects on ART-outcomes, geriatric conditions, and nutritional status together with health-interventions aimed to reduce it is presented in this review. A literature search was conducted on the MEDLINE database for all relevant English- and Spanish-language studies since 2006...

BACKGROUND: Cardiac surgery patients with prolonged stay in the intensive care unit (ICU) are at high-risk for acquired malnutrition. Medical nutrition therapy practices in cardiac surgery patients are unknown. The objective of this study is to describe current nutrition practices in critically ill cardiac surgery patients worldwide. METHODS: We conducted a prospective observational study in 13 international ICUs involving mechanically ventilated cardiac surgery patients with an ICU stay of at least 72 hours...

OBJECTIVE: To assess the pharmacist's contributions by analyzing potentially inappropriate prescription and home treatment reconciliation in the complex chronic patient unit of a tertiary hospital. METHOD: Observational, prospective, multidisciplinary study of patients in the complex chronic patient unit of a hospital during February 2019-June 2020. Multidisciplinary team of the complex chronic developed a checklist with a selection of non-recommended drugs based on STOPP/START, Beers and Priscus criteria, and drugs susceptible to deprescription according to LESS-CHRON criteria...

There is no published evidence on the possible differences in multimorbidity, inappropriate prescribing, and adverse outcomes of care, simultaneously, from a sex perspective in older patients. We aimed to identify those possible differences in patients hospitalized because of a chronic disease exacerbation. A multicenter, prospective cohort study of 740 older hospitalized patients (≥65 years) was designed, registering sociodemographic variables, frailty, Barthel index, chronic conditions (CCs), geriatric syndromes (GSs), polypharmacy, potentially inappropriate prescribing (PIP) according to STOPP/START criteria, and adverse drug reactions (ADRs)...

OBJECTIVES: To investigate the effect of integrated medicines management provided to hospitalised multimorbid patients on the quality of drug treatment at discharge measured as the mean number of potential prescribing omissions and potentially inappropriate medicines. METHODS: Multimorbid patients ≥18 years, using a minimum of four regular drugs from a minimum of two therapeutic drug classes, were recruited from the Internal Medicine ward, Oslo University Hospital, Norway, from August 2014 to March 2016 and randomly assigned, 1:1, to the intervention or control group...

PURPOSE: To evaluate the appropriateness of medication prescribing and to analyze interventions carried out in polymedicated elderly patients in nursing homes (NHs). METHODS: Prospective study of potentially inappropriate medication prescribing in polymedicated older adults living in NHs, implemented via a collaborative project between NHs and the geriatric and pharmacy departments of a university hospital. The pharmacist reviewed patients' active medical prescriptions and prepared an individualized report with proposals aimed at therapeutic optimization that was sent for evaluation to the geriatrician in charge of the NH...

Background: Little research addressed deprescribing-focused medication optimization interventions while utilizing implementation science. This study aimed to develop a pharmacist-led medication review service with a deprescribing focus in a care facility serving patients of low income receiving medications for free in Lebanon followed by an assessment of the recommendations' acceptance by prescribing physicians. As a secondary aim, the study evaluates the impact of this intervention on satisfaction compared to satisfaction associated with receiving routine care...

INTRODUCTION: Numerous tools exist to detect potentially inappropriate medication (PIM) and potential prescribing omissions (PPO) in older people, but it remains unclear which tools may be most relevant in which setting. OBJECTIVES: This cross sectional study compares six validated tools in terms of PIM and PPO detection. METHODS: We examined the PIM/PPO prevalence for all tools combined and the sensitivity of each tool. The pairwise agreement between tools was determined using Cohen's Kappa...

The demand for long-term care is expected to increase due to the rising life expectancy and the increased prevalence of long-term illnesses. Nursing home residents are at an increased risk of suffering adverse drug events due to inadequate prescriptions. The main objective of this systematic review is to collect and analyze the prevalence of potentially inadequate prescriptions based on the new version of STOPP/START criteria in this specific population. Databases (PubMed, Web of Science and Cochrane) were searched for inappropriate prescription use in nursing homes according to the second version of STOPP/START criteria...

OBJECTIVE: The aim of this study was to identify the prevalence of potentially inappropriate drug prescribing1 (PIDP) using a combination of explicit and implicit criteria in a sample of Lebanese older adults taking 5 or more chronic medications per day in ambulatory care settings and to identify which factors were associated with PIDP. The explicit criteria included five different lists: Beers, Laroche, European Union (EU(7)-PIM list), STOPP/ START, STOPP Frail, and Alert and Mastering of Iatrogenesis issued by the French High Authority of Health...

BACKGROUND: On the basis of low-quality evidence, international critical care nutrition guidelines recommend a wide range of protein doses. The effect of delivering high-dose protein during critical illness is unknown. We aimed to test the hypothesis that a higher dose of protein provided to critically ill patients would improve their clinical outcomes. METHODS: This international, investigator-initiated, pragmatic, registry-based, single-blinded, randomised trial was undertaken in 85 intensive care units (ICUs) across 16 countries...

UNLABELLED: BACKGROUND : Polypharmacy is a common global health concern in the older population. Deprescribing has been acknowledged as an important aspect of medication use review that helps to reduce polypharmacy, inappropriate medication uses and medication adverse events, thus ensuring medication optimization and improving health-related quality of life. As physicians are primarily responsible for prescribing and monitoring of drug therapy, their perception of deprescribing and knowledge of available deprescribing tools is highly important...

In Saudi Arabia, the older adult population is growing and is projected to increase three-fold by 2030. Potentially inappropriate medications (PIMs) are harmful to older adults' and have a direct impact on clinical, health and economic outcomes. Pharmacists have a vital role in medication tailoring for older adults as multidisciplinary team members. However, there is also a paucity of research regarding pharmacists' participation in detecting and avoiding PIMs use among older adults in Saudi Arabia. A cross-sectional, self-administered survey was conducted to assess the knowledge, practices, and attitude of pharmacists from seven hospitals and ten community pharmacies in Jeddah, Saudi Arabia...