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and mortality (OR 0.53 (95% CI 0.31 –0.91) [8]. The number needed to
treat to reduce re-admission at 18 months was 10 [4].
Key conclusions: There is a lack of available studies and statistical
power. Nevertheless, odds of mortality following CGA are half the
odds of death with no CGA at 4 months [8]. Logistically, CGA can be
conducted within EDs. Emphasis should be made to highlight CGA to
clinicians within EDs. It remains unclear which intervention would be
most clinically or cost effective. Larger trials are necessary to provide
further impetus for change.
References
[1] NHS Benchmarking Network, Older People in Acute Settings
Benchmarking report. Raising standards through sharing excel-
lence. 2015.
[2] Quality Care for Older People with Urgent & Emergency Care
Needs. Silver Book. The British Geriatric Society, 2012.
[3] Basic D. and Conforti D.A., A prospective, randomised controlled
trial of an aged care nurse intervention within the Emergency
Department. Australian Health Review, 2005. 29(1): 51–59.
[4] Caplan G.A., et al., A randomized, controlled trial of comprehensive
geriatric assessment and multidisciplinary intervention after
discharge of elderly from the emergency department–the DEED
II study. J Am Geriatr Soc, 2004. 52(9): 1417–23.
[5] Close J., et al., Prevention of falls in the elderly trial (PROFET): a
randomised controlled trial. Lancet , 1999. 353(9147): 93–7.
[6] Davison J., et al., Patients with recurrent falls attending Accident &
Emergency benefit frommultifactorial intervention–a randomised
controlled trial. Age & Ageing. 34(2): 162–8.
[7] Hendriksen H. and Harrison R.A., Occupational therapy in accident
and emergency departments: a randomized controlled trial.
Journal of Advanced Nursing. 36(6): 727–32.
[8] McCusker J., et al., Rapid emergency department intervention
forolder people reduces riskof functional decline: results of amulti-
center randomized trial. J Am Geriatr Soc, 2001. 49(10): 1272–81.
[9] Mion L.C., et al., Case finding and referral model for emergency
department elders: a randomized clinical trial. Ann Emerg Med,
2003. 41(1): 57–68.
[10] Shaw F.E., et al., Multifactorial intervention after a fall in older
people with cognitive impairment and dementia presenting to
the accident and emergency department: randomised controlled
trial. [Erratum appears in BMJ. 2003Mar 29;326(7391):699].BMJ.
326(7380): 73.
[11] Runciman P., et al., Discharge of elderly people from an accident
and emergency department: evaluation of health visitor follow-
up. J Adv Nurs, 1996. 24(4): 711–8.
P-258
Potentially inappropriate prescribing in elderly patients on
anticoagulant therapy: application of the STOPP/START criteria
J. Madeira 1, S. Queimado2, J. Martinez2, G. Alves1,3,4. 1FCS-UBI – Faculty
of Health Sciences of the University of Beira Interior, Covilhã,
2ULSCB – Local Health Unit of Castelo Branco, Castelo Branco, 3CICS-UBI –
Health Sciences Research Centre, University of Beira Interior, Covilhã,
4CNC – Centre for Neuroscience and Cell Biology, University of Coimbra,
Coimbra, Portugal
Introduction: The STOPP/START criteria (Screening Tool of Older
Person’ s Prescriptions/Screening Tool to Alert doctors to the Right
Treatment) constitute a validated tool to optimize pharmacotherapy in
elderly patients ( ≥65 years). These criteria aim to improve the
pharmacological treatment in elderly by identifying potentially
inappropriate medications (PIM) and potentially prescribing omis-
sions (PPO) useful in the prevention or treatment of diseases.
Methods: A descriptive observational study was performed, which
focused on medication review, diagnostics and biochemical para-
meters of patients aged 65 years or over, with four or more
medications, followed on anticoagulation consultations.
Results: The final sample included 73 patients [mean age 75.78 years
(range 65–91)], 53.4% female, with an average of 9.32 (±2.86)
prescription drugs and 3.27 (±2.10) diagnoses involved in the criteria.
The collected data allowed to identify at least one PIM and one
PPO in 80.8% and 41.1% of the patients, respectively. Applying the
STOPP criteria, the drugs most frequently implicated were benzodia-
zepines for ≥ 4 weeks (45.2%), nonsteroidal anti-inflammatory drugs
in combination with an anticoagulant (21.9%), and the use of first-
generation H1-antihistamines (12.3%); duplicate drug class prescrip-
tion was also detected in 16.4% of the patients. Moreover, according
to the START criteria, the most commonly identified PPO were
inhaled beta-2 or antimuscarinic bronchodilators (12.3%), vitamin D
supplements (11%), and appropriate beta-blockers in systolic heart
failure (11%).
Key conclusions: The STOPP/START criteria reveal that PIM use and
PPO detected are highly prevalent among elderly patients receiving
anticoagulant therapy. These results reinforce the need of integrated
interventions for an appropriate pharmacotherapy management in
geriatric patients.
P-259
Factors influencing length of stay in hospitalised elderly
patients – a hospital based practice review
R. Mahmood, R. Jeyarajah. Ashford and St Peter NHS Foundation Trust,
United Kingdom
Introduction: In current challenging economic climate and likely
reduced National Health Service (NHS) growth, productivity and
efficiency are paramount. Considering average cost for a patient to stay
in an NHS ward is up to £400 per day, the financial benefits of reducing
length of stay (LOS) are huge. Reducing hospital admissions and
caring for people more appropriately outside of hospital is the key to
success. Several factors including comorbidities and functional
limitations has been identified which influence patient’ s overall LOS.
Improving patient turn over and reducing LOS is essential in current
NHS economic climate.
Method: In St Peters Hospital, Chertsey, a district general hospital,
retrospective data on 743 patients’ demographics, comorbidities,
functional and cognitive status, outcome and median LOS over a
period of 12 months (November 2013 to October 2014) was collected
from hospital IT records, electronic discharge summaries, hospital
medical notes and records. The data was analysed and compared.
Median values are provided.
Results: Patient who stayed longer were older with age between 85
and 99 years (12 days), required new care home (22 days), had
dementia (12 days), had ongoing medical illness (LOS >2 weeks), were
dependent (11 days) and presented with falls (11 days).
Conclusions: Elderly patients have complex needs. Quick identifica-
tion and comprehensive geriatric assessment with prompt manage-
ment of acute medical and functional problems with early discharge
planning involving family may reduce length of stay in hospital.
P-260
Pain assessment and management in elderly people: relationship
with depression and quality of life. A multicenter Italian study
A. Malara1, R. Cerbo2, A. De Santis1, A. Ainis1, P.P. Gasbarri1, G.A. De
Biase1, V. Rispoli1, I. Bruno1, S. Capurso1, M. Garo1, P. Moneti1,
G. Pirazzoli1, F. Bettarini1, F. Biondi1, B. Brognara1, E. Caggese1, I. Capell.
1Scientific Committee of National Association of Third Age Residences
(ANASTE), Roma, I-Italy, 2Centro HUB Policlinico Umberto I Roma I-Italy
Introduction: Pain is under-detected and under-treated in elderly.
This study investigates the prevalence of pain in elderly admitted
to Long Term Care Facilities of National Association of Third Age
Structures (ANASTE) and evaluates the association between pain,
mood and quality of life.
Methods: A multicenter prospective observational study was con-
ducted on 1089 subjects at T0 (April 2014) and on 1077 subjects at
T1 (July 2014), after a training period of the care staff on pain
management. All subjects were subjected to multidimensional
geriatric evaluation. The pain assessment was performed using the
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S97