Potentially inappropriate prescriptions of antithrombotic therapies in older outpatients: a French multicenter cross-sectional study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-18

AUTHORS

Ségolène Dubois-Puechlong, Frédéric Mille, Patrick Hindlet, Yann de Rycke, Florence Tubach, Christine Fernandez, Dominique Bonnet-Zamponi

ABSTRACT

To assess the prevalence of inappropriate prescriptions of antithrombotic therapies (AT) in older outpatients, and to examine the associated factors. 22.6% patients featured ≥ 1 in AT-STOPP criteria, 12.4% ≥ 1 in AT-START criteria. The most frequent AT-STOPP criterion was AT prescription despite a concurrent significant bleeding risk. The most frequent AT-START criterion was lack of AT prescription for patients with chronic atrial fibrillation. Two factors were associated with ≥ 1 AT-STOPP criteria: polymedication and previous hospitalization for a serious adverse drug event. The only factor associated with ≥ 1 AT-START criteria was lack of information in the prescription regarding the duration of treatment. Suboptimal prescribing of AT is common in GP’s prescriptions for older autonomous outpatients. Special attention should be given to those with polymedication and a history of severe adverse drug event. To assess the prevalence of inappropriate prescriptions of antithrombotic therapies (AT) in older outpatients and examine the associated factors. A multicenter cross-sectional study was performed in 75 community pharmacies of 11 French districts. The study included 1178 patients aged ≥ 75 years filling a prescription from a general practitioner (GP) at a community pharmacy (mean [SD] age 83 [± 5.5] years, 59% female, median prescribed drugs 7 [range 5–10]).75 pharmacy students prospectively collected data from structured interviews with patients and from prescriptions into an electronic case report. Updated 2014 STOPP/START criteria regarding AT were applied to each prescription. Factors associated with ≥ 1 AT-STOPP criteria and ≥ 1 AT-START criteria were studied (multivariate analysis). 22.6% patients featured ≥ 1 in AT-STOPP criteria and 12.4% ≥ 1 in AT-START criteria. The most frequent AT-STOPP and AT-START criteria were AT prescription despite a concurrent significant bleeding risk and lack of AT prescription for patients with chronic atrial fibrillation, respectively. Two factors were associated with ≥ 1 AT-STOPP criteria: polymedication (≥ 5 drugs; p < 0.001) and previous hospitalization for a serious adverse drug event (ADE; p = 0.007). The only factor associated with ≥ 1 AT-START criteria was lack of information in the prescription regarding the duration of treatment. Suboptimal prescribing of AT is common in GP’s prescriptions for older autonomous outpatients. The currently process of prescribing AT to older autonomous patients must be improved. Special attention should be given to those with polymedication and those with a history of severe ADEs. More... »

PAGES

1-9

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s41999-019-00176-2

DOI

http://dx.doi.org/10.1007/s41999-019-00176-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112849976


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38 schema:description To assess the prevalence of inappropriate prescriptions of antithrombotic therapies (AT) in older outpatients, and to examine the associated factors. 22.6% patients featured ≥ 1 in AT-STOPP criteria, 12.4% ≥ 1 in AT-START criteria. The most frequent AT-STOPP criterion was AT prescription despite a concurrent significant bleeding risk. The most frequent AT-START criterion was lack of AT prescription for patients with chronic atrial fibrillation. Two factors were associated with ≥ 1 AT-STOPP criteria: polymedication and previous hospitalization for a serious adverse drug event. The only factor associated with ≥ 1 AT-START criteria was lack of information in the prescription regarding the duration of treatment. Suboptimal prescribing of AT is common in GP’s prescriptions for older autonomous outpatients. Special attention should be given to those with polymedication and a history of severe adverse drug event. To assess the prevalence of inappropriate prescriptions of antithrombotic therapies (AT) in older outpatients and examine the associated factors. A multicenter cross-sectional study was performed in 75 community pharmacies of 11 French districts. The study included 1178 patients aged ≥ 75 years filling a prescription from a general practitioner (GP) at a community pharmacy (mean [SD] age 83 [± 5.5] years, 59% female, median prescribed drugs 7 [range 5–10]).75 pharmacy students prospectively collected data from structured interviews with patients and from prescriptions into an electronic case report. Updated 2014 STOPP/START criteria regarding AT were applied to each prescription. Factors associated with ≥ 1 AT-STOPP criteria and ≥ 1 AT-START criteria were studied (multivariate analysis). 22.6% patients featured ≥ 1 in AT-STOPP criteria and 12.4% ≥ 1 in AT-START criteria. The most frequent AT-STOPP and AT-START criteria were AT prescription despite a concurrent significant bleeding risk and lack of AT prescription for patients with chronic atrial fibrillation, respectively. Two factors were associated with ≥ 1 AT-STOPP criteria: polymedication (≥ 5 drugs; p < 0.001) and previous hospitalization for a serious adverse drug event (ADE; p = 0.007). The only factor associated with ≥ 1 AT-START criteria was lack of information in the prescription regarding the duration of treatment. Suboptimal prescribing of AT is common in GP’s prescriptions for older autonomous outpatients. The currently process of prescribing AT to older autonomous patients must be improved. Special attention should be given to those with polymedication and those with a history of severe ADEs.
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