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

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[95% CI −33.9, −11.4] among those without such symptoms. This
reduction was ameliorated but still significant in the multivariable
analysis (ß-estimate −18.2 min/day [95% CI −28.9, −7.6]).
Conclusion: Our results suggest a differential association of anti-
depressants with PA in subjects with/without depressive symptoms.
Antidepressants use was clearly associated with a reduction of PA
among participants without symptoms.
P-768
No impact of pharmaceutical intervention evaluated using the
STOPP/START criteria; a case-control study
S. Danevad 1, I. Barat2. 1Division of Geriatrics, Department of Internal
Medicine, Horsens Hospital, Horsens, 2Division of Geriatrics, Department
of Internal Medicine, Horsens Hospital, Horsens, Denmark
Introduction: Studies show that one in three admissions of patients
over 75 years old are related to adverse drug events(ADEs) connected
with inappropriate medications. Pharmaceutical intervention(PI) is
introduced in many hospitals to face this problem. STOPP/START
(StpStr) criteria is a screening tool for medical prescriptions for older
people(STOPP) and alerting to the right treatment(START). Studies
show that the tool is effective in identifying potentially inappropriate
medication (PIMs) and avoiding ADEs. PI has been shown to improve
appropriateness of prescriptions to elderly. Few previous studies have
evaluated PI using StpStr criteria.
Objectives: To use StpStr to compare the appropriateness of medi-
cation of elderly patients receiving PI to those that did not, on
discharge from a medical ward. METHODS: A two month retrospective
case-control study including all patients 65 years or older admitted
and discharged from our internal medical ward in a regional hospital
in Denmark. At discharge, a geriatrician resident evaluated the
patients` prescription using the criteria.
Results: Of the 213 patient included, 74 received PI and 139 did not.
No inappropriate medications were seen in 7(9.5%) patients from the
case-group and 15(10,8%) from the control-group. One or more
inappropriate medication were seen in 67(90.4%) patients from the
case-group and 124(89,2%) from the control group. No difference in
medication quality were found between the groups, RR 0,82(95%CI
0,35;1,94).
Conclusion: This study showed that PI has no impact on medication
quality evaluated by the StpStr criteria. Due to the complexity of the
issue and the small size of the study we suggest further larger scale
studies.
P-769
Description of a reality. Proton-pump inhibitor in elderly
hospitalized
M.C. Deza, B. Gamboa, I. Ferrando, M.M. González, C.M. Bibian. Hospital
Nuestra Señora de Gracia, Zaragoza, Spain
Objectives: 1. Describe the characteristics of elderly patients taking
proton-pump inhibitor (PPI) admitted in a Geriatric Unit. 2. Evaluate
the type of IBP most used and the most frequent causes of this
treatment indication. 3. Analyze the adequacy PPI treatment.
Methodology: Patients admitted from June to November 2014.
Descriptive, prospective study. Variables: sociodemographic, personal
history (AP), functional assessment (I. Barthel- IB), cognitive assess-
ment (SPMSQ), comorbidity (Charlson index), biochemical para-
meters. SPSS. Treatment criteria according to data sheet indication
IBP and according to the recommendations of the Clinical Practice
Guideline job IBP (Health 2011).
Results: 318 revenue. IBP treatment: 58.80% (187 patients). Of these,
74.3% women. Average age: 86.4. SPMSQ: 6.02. IB median income
and high 20. 40 AP: 84% cardiovascular, neurological 65.2%, 40.1%
nefrourológico, respiratory and sensory 31.6%, anemia 70.1%, 52.4%
hypoalbuminemia. I. Charlson income 3 and the high 7 (median).
Exitus 13.4%. IBP: 75.4% Omeprazole, pantoprazole and lansoprazole
7.5%, 5.9% esomeprazole, rabeprazole 1.6%. Meets 70% adequate
indication. Note: Antiplatelet 71%, 21.4% oral anticoagulant classic,
UGD: 10.7% NSAIDs gastropathy: 9.2% Corticosteroid: 6.9%. The rest of
the sample that does not take PPI treatment, meets indication: 49.6%.
Conclusion: These preliminary results show that more than half of
our patients consume omeprazole, with a high percentage of suitable
indication according to the criteria considered in the study.
Antiplatelet making the most frequent prescription of PPIs reason.
Indeed, we believe corresponds to the reality of our patients, with
significant cardiovascular morbidity and risk of gastro-events.
P-770
Is depression a predictive factor for polypharmacy in elderly?
A. Doventas, M. Yuruyen, H. Yavuzer, F. Demirdag, Z. Kara, M. Cengiz,
S. Yavuzer, S. Avci, D.S. Erdincler. Department of InternalMedicine,
Division of Geriatrics, University of Istanbul, Cerrahpasa School of
Medicine, Istanbul, Turkey
Objectives: This study was sought to investigate polypharmacy rates
and drug use characteristics in elderly patients in our country.
Methods: In a retrospective design, we reviewed hospital records of
1,205 patients (≥65 years) who applied to our geriatric outpatient
clinic. Demographic characteristics, polypharmacy, drugs used at
presentation and final evaluation, and comorbid conditions were
recorded. The use of five or more drugs was considered to be poly-
pharmacy. Binary logistic regression analysis was performed.
Results: The average age was 75.2 ± 6.9. The number of comorbidities
was 2.46 ± 1.3. The number of drugs used at first application and final
evaluation was 3.8 ± 2.7 and 4.3 ± 2.8 (p < 0.001), polypharmacy rates
of 40% and 45% (p < 0.001). The number of drugs used in the final
evaluation of patients ranged from 0 to 17. The rates of patients using
one drug, two drugs, three drugs and four drugs were 6.3%, 10.5%,
12.8% and 15.4%, respectively. The most common five comorbidities
were hypertension (67%), diabetes mellitus (27%), osteoporosis (27%),
hyperlipidemia (25%) and depression (20%). Depression was an
independent predictive factor for polypharmacy than other comorbid
diseases in the regression analysis (OR: 4.5; 95% CI: 3.2–6.5; p < 0.001).
The rates of drugs acting on the central nervous system (sedative-
hypnotics, antidepressants and antipsychotics), anticholinergics, and
diuretic drugs were significantly higher (p < 0.001) in polypharmacy
group than non-polypharmacy group.
Conclusions: Although patients were examined in detail in terms of
polypharmacy, it was found to be as high as 45%. Before starting an
additional medication in elderly patients, particularly with depres-
sion, the indication should be clearly specified, and several aspects
should be taken into consideration, including functional capacity of
the patient, the drugs already used and possible interactions of the
new drug.
P-771
Hypoalbuminemia in older patients drug therapy – should we be
worried?
A. Watts Soares1, A. Loba2, T. Lobo2, M. Maia1, Y. Mamede1, M.J. Serpa1,
S. Duque3,4, S. Velho5, M. Capoulas2, F. Araújo1, J. Pimenta da Graça 1.
1Hospital Beatriz Ângelo – Internal Medicine Department, 2Hospital
Beatriz Ângelo – Pharmacy Department, Loures, 3Centro Hospitalar de
Lisboa Ocidental – Hospital São Francisco Xavier – Internal Medicine
Department, 4Unidade Universitária de Geriatria – Faculdade de
Medicina – Universidade de Lisboa, Lisboa, 5Hospital Beatriz Ângelo –
Nutrition and Dietetics Department, Loures, Portugal
Introduction: Hypoalbuminemia is frequently seen in the elderly due
to malabsorption and malnutrition and its consequences in pharma-
codynamics and pharmacokinetics are known. However, it is rarely
approached by the clinician regarding the implications it might have
in drug prescription and side effects.
Aim: analysis of prescription of acidic drugs that readily bind to
albumin.
Methods: Retrospective study of a cohort of 100 patients ≥ 75 years
admitted in an Internal Medicine ward. Comprehensive geriatric
assessment at admission. Assessment of chronic medication and
Poster presentations / European Geriatric Medicine 7S1 (2016) S29–S259 S232