European Geriatric Medicine - Supplement 1 - Volume 7 - October 2016

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Area: Pharmacology
P-753
Potentially inappropiate prescribing according to stopp and start
criteria in an acute geriatric unit in Tenerife
C. Arango1, B. Grandal1, J. Alonso2, M. Dávila1, R. Quilez1, H. Aldoradin1.
1Acute Geriatric Unit Hospital Universitario Nuestra Señora de La
Candelaria, Tenerife, 2Hospital Insular de Lanzarote, Lanzarote,
Spain.
Objectives: Polypharmacy is a key problem for older adults. The aim of
this study was to describe the prevalence of Potentially Inappropriate
Medications (PIMs) and Potential Prescribing Omissions (PPOs) in an
Acute Geriatric Unit.
Methods: This retrospective cross-sectional analysis included 1117
patients hospitalized in our unit from April 2014 to December 2015.
PIMs was defined by the Screening Tool for Older Persons Prescriptions
(STOPP) and Screening Tool to Alert doctors to Right Treatment
(START) in its last version. Descriptive statistics were used to analyze
and present the collected data which included demographic, hospital
stay, the reason for admission, functional status, comorbidity and
polypharmacy.
Results: In this aged population (median age 84 years, 65% female) 47%
showed high morbidity rates and polypharmacy (five or more long-
term drugs) was detected in 89% of the patients. The average of
hospital stay was 9 days. The screening detected START-PIMs in 54.3%
of patients and STOPP-PIMs in 65.9%. Benzodiazepines, neuroleptics
were the most prevalence PIMS with 40% and 16% of the patients. The
most common PPOs were AChEI, ACE inhibitor, and antiplatelet which
were detected in 20%, 20% and 15% respectively.
Conclusions: Potentially inappropriate prescribing is highly prevalent
in older adults. Our framework consist on very old dependent patients
with high comorbidity, polypharmacy and time limitations in the
acute settings, therefore pharmacotherapy reduction is challenging.
Next step is to create additional geriatric health care service in order to
provide continuity of care which may reduce inadequate prescription
still further.
P-754
The use of psychoactive drugs in the institutionalized and non-
institutionalized elderly
G.G. Arumugamm1, I. Coelho1, S. Martins1, A.R. Sanches1, M. Sousa 1,
M. Carvalho1, F. Pimenta1, M. Kirzner1. 1Centro Hospitalar do Médio Tejo,
Abrantes, Portugal
Objectives: Several documented studies have shown that the
consumption of psychoactive drugs is high among the institutiona-
lized aged population. This study was carried out to determine the use
of benzodiazepines, antidepressants and antipsychotics in the insti-
tutionalized and non-institutionalized elderly.
Methods: A cross sectional study using computerized hospital
discharge data in 336 institutionalized (n = 193) and non-institutio-
nalized (n = 143) patients (>65 years) during the first three weeks of
January 2015, from an Internal Medicine ward in a district hospital in
the Medio Tejo area in Portugal.
Results: The average age was higher in the institutionalized com-
pared to the non-institutionalized patients (83.79; 95% CI 82.59–84.99
versus 81.26; 95% CI 80.20–82.27). There were no significant dif-
ferences between the average utilization of polymedication in both
groups (7,53; 95% CI 7.02 –8.04 versus 6,78; 95% CI 6.30–7.26). In
general, benzodiazepine use was the highest in elderly females (non-
institutionalized with 38.29%, n = 43/112 versus institutionalized
with 35,23%; n = 31/88). No major differences were noted in relation
to the consumption of antidepressants and antipsychotics. There
was a significant difference of each drug prescribed to institutiona-
lized elderly males with the majority being benzodiazepines (23.63%;
n = 13/55) followed by antidepressants (18.18%; n = 10/55) and
antipsychotics (16.63%; n = 9/55). Mortality rate of those using
psychoactive drugs were 78.08%; n = 57/73.
Conclusion: High consumption of psychoactive drugs was widely
used in both institutionalized and non-institutionalized elderly,
especially in females. More than three quarters of the overall number
of mortalities had psychoactive drugs as part of their medications.
P-755
Laxative use in the geriatric population in long-term care and
association to patients’ medication
A. Attard1, M. Abela2. 1Mater Dei Hospital, L-Imsida, 2Rehabilitation
Hospital Karin Grech, Pieta, Malta
Introduction: Laxatives are commonly used especially in elderly in
long-term care. Correlation between laxative use and constipating
drugs was evaluated.
Method: This cross-sectional survey, carried out between November
and December 2015, included 246 patients residing at Saint Vincent de
Paule Residence (SVPR) and Zejtun Home in Malta. The patients’
treatment charts were analysed and the following variables were
recorded: patient’s ID, age, regular laxative use, type of laxative and
use of concomitant constipating drugs. Drugs causing constipation as a
major side-effect were listed. Data was analysed and trends were
tabulated. Calculations demonstrating frequency of regular laxative
use, gender difference, age stratification and effect of constipating
drugs on regular laxative use were carried out.
Results: 41.87% of patients were on regular laxatives with little
difference betweenmales and females.11.65% of patients neededmore
than one laxative. Use of laxatives was higher in the 75+ age group.
Lactulose was the commonest used laxative. 40% of patients on
laxatives were also on constipating drugs however 58% of patients on
laxatives were not on any constipating drugs. 25% of patients whowere
not on regular laxative use were on constipating drugs.
Key conclusions: There is a modest association between consti-
pating drugs and regular laxative use. Constipation in elderly is
multifactorial. Use of laxatives must be tailored to the patient’ s
medical history, drug interactions, costs and side-effects. Laxatives are
not completely safe but contra-indications, including intestinal
obstruction, exist. Laxative abuse must be controlled to avoid
electrolyte disturbances [1] [2].
References
1. Bouras EP, Tangalos EG. Constipation in the Elderly. Gastroenterol
Clin North Am . 2009 Sep; 38(3):463–80.
2. Gunvor F, Stian L, Per F. Drugs and constipation in elderly in
nursing homes: What is the Relation? Gastroenterol Res Pract. 2012;
2012:290231.
P-756
Prevalence of potentially inappropriate prescribing among older
adults: a comparison of the Beers 2012 and Screening Tool of Older
Person’s Prescriptions (STOPP) Criteria Version 2
G. Bahat1, I. Bay1, A. Tufan2, F. Tufan 1, C. Kilic 1, M.A. Karan1. 1Department
of Internal Medicine, Division of Geriatrics, Istanbul Medical School,
2Department of Internal Medicine, Division of Geriatrics, Marmara
University Hospital, Istanbul, Turkey
Objectives: There is not any study comparing the Beers 2012 and
STOPP version 2 criteria nor reporting Prevalence of Potentially
Inappropriate Prescribing (PIM) with STOPP version 2. We aimed
to evaluate the prescriptions of patients admitted to geriatric
outpatient clinic with these tools and document factors related to
PIM use.
Methods: Older patients (>65-years) admitted to outpatient clinic
of a university hospital were retrospectively evaluated for PIM
with Beers 2012 and STOPP version 2 criteria. Age, sex, chronic
disease and drug numbers, functional, depression and nutritional
statuses were studied with regression analysis as possible factors
related to PIM.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S228