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Departments (EDs) but is often inconsistent. The authors determine

the benefit of introducing STOPP/START for frail patients in ED and its

impact on polypharmacy.


Prospective interventional cohort study in the ED of a British

University Hospital over an 8-week period. All patients admitted to the

ED Frailty Unit included. STOPP/START criteria applied. Statistical

analysis performed in SPSSv23.


173 cases identified. Median age 87 (92

82) years old, 74.4%

female, Clinical Frailty Scale 6 (6

4), Cumulative Illness Rating Scale-

Geriatrics 10 (14

6), 51.1% presenting with falls. Overall, patients

had 7 (10

5) drugs on admission, 29.4% PIM and an indication to

start treatment in 13.9% of cases. Patients discharged home from ED

had fewer drugs on depart than those leaving wards (p = 0.038).

Systematic use of STOPP/START criteria in frail elderly in ED allowed a

significant reduction in polypharmacy (p = 0.019). Most commonly

discontinued drugs were bisphosphonates (12.3%), proton-pump

inhibitors (12.3%), and loop diuretics (9.6%). This intervention promp-

ted discontinuation of further drugs not included in STOPP/START.


To our knowledge this is the first study to focus exclu-

sively on frail patients assessed in ED. Almost a third of frail elderly

patients presented with PIM. Moreover, active screening resulted in a

significant reduction in polypharmacy. Finally, this study represents a

contribution to the development of a deprescribing policy in our



Falls of older patients: the influence of drugs

M.M. Moraes


, M.A. Soares


, J. Gorjao Clara




Faculty of Pharmacy of

Lisbon University, Geriatric University Unit, Faculty of Medicine of Lisbon



Faculty of Pharmacy of Lisbon University,



University Unit, Faculty of Medicine of Lisbon University


Falls among the older patients are associated with high

morbidity and mortality. The incidence of falls increases with age.

History of falls, muscle weakness, dementia, neurologic disorders,

visual impairment and medication use, are some risk factors for falls.

Polypharmacy is associated with adverse outcomes and drugs like

benzodiazepines, hypnotics, antipsychotics, antidepressants, antic-

holinergics, dopaminergic drugs or medication which cause postural

hypotension, are associated with a significant risk of falls.


To characterize the pharmacological profile of older patients


65 years old) with falls.


Cross-sectional study. Data were collected during their 1st

attendance in geriatric medicine.


We studied 215 patients (144 women; 71 men), media age of

80.4 (65

93) years old. Media drugs/patient was 7.8 (0

19). All

patients took medications that may increase the falls risk or may

cause/worsen orthostatism; 41 (19.1%) patients, with mean age 81.3

years old had history of falls. The highest frequency of falls was in

women (75.6%), and in patients with age between 75 and 84 years old.

In the falls group media drugs/patient was 9 (0

18) and 75.6% was

taken one or more potential inappropriate medication according to

Beers 2015.


Medications associated with increased risk of falls were

prescribed in all studied patients. Patients with falls were in the older

group (mean age 81.3). These patients took more drugs (9.0) than the

group without falls (7.6). To reduce falls, in the prescription for older

patients we should avoid inappropriate drugs, take attention to correct

doses and reduce the number (as possible) of drugs/patient.


Clinical and pharmacological correlations in geriatrics

A. Mota, C. Eira, R. Silvério, A. Monteiro.

Internal Medicine Department

Centro Hospitalar Tondela-Viseu, E.P.E.


Elderly people have multiple co-morbidities, leading to

greater functional disability and polypharmacy. Particular pharmaco-

logical properties increases the adverse reactions possibility. The

aim of this study was to determine clinical and pharmacological

correlations in geriatric population. METHODS: A prospective study

was performed on 106 patients, who were 65 years and older,

hospitalized on the same day in Internal Medicine department of a

centralized hospital in Portugal. We sought to identify the relation-

ships between: sex, age (<80;

80), living in elderly care institutions

(LECI), autonomy degree (Katz scale: high, moderate dependence and

independent), number of pathologies (


4), fall/fracture history,

Morse scale (<51;

51), total (


8) and potentially inappropriate (PI:


1) number of drugs (Beers criteria). RESULTS: More than half (53%)

of the sample was female and 76% were 80 years and older. About 92%

had high dependency, 20% were LECI and 19% were at high risk of

falling. On average, they had 3.72 pathologies and were treated with

7.58 drugs, of which 50% were PI (75% neurologic medication). There

was withdrawal of the drug in 11%, yet only 3% was determined

association with hospitalization. Respiratory pathologies accounted

47% of admissions and mortality was 13%. Older patients had high

dependence (p = 0.007). LECI was associated to PI drugs (p = 0.003),

but with less fall/fracture history (p = 0.048). Total (p < 0.001) and

PI (p = 0.008) number of drugs increased with the number of

pathologies. Number of PI drugs increased with the total number of

drugs (p < 0.001). CONCLUSION: Pharmacological management

should be dynamic, requiring greater training and individualization

of hospital care.


Inappropriate prescription of PPI

s and statins and their

contribution to poly-medication in elderly

A. Mouzon


, V. Mignon


, B. Hamoir


, D. Schoevaerdts


, A. Spinewine



C. Swine



Université catholique de Louvain CHU UCL Namur, Belgium;


Clinical Pharmacy,


Geriatric Medicine Departments


Poly-medication is frequently observed in frail older

patients assessed by the liaison team in the hospital. Proton pump

inhibitors (PPI

s) and Statins are often part of the regimens. The aim of

this study was to assess the appropriateness of these prescriptions and

to analyze their contribution to poly-medication.


Fifty-one successive geriatric patients aged 82.2 ± 4 years,

screened at risk by ISAR were enrolled. Demographic data,

Short Emergency Geriatric Assessment score (SEGA), total number of

drugs taken and the prescriptions of PPI

s or Statins were recorded.

Inappropriate prescriptions (IP) of these 2 drugs were assessed

according to the EBM for Statins, and to the Belgian reimbursement

criteria for the PPI



The geriatric profile of the patients was illustrated by the high

median SEGAscore (12/26; 82% > 8/26), and the mean number of

medications of 8.0 ± 3.6 . Prescription of Statins was observed for

24 patients (47%) of whom 6 IP (25%); while 25 patients (49%) had a

PPI prescribed, with 19 IP (76%). The IP were increasing with older age

for PPI

s (p = 0.047), and decreasing for Statins (p = 0.025). The Statins

IP are associated with a poly-medication of 11 vs 8 medications

(p = 0.054) and of 10 vs 7 drugs for IPP

s (p = 0.047).



s and statins are frequently prescribed and need

to be taken into account in the revision of the treatments. Not only

to prevent their own side effects, but also as indicators of poly-

medication and possible additional IP.


Antipsychotics agents in dementia

C. Neves


, P. Almeida




Unidade de Saúde Familiar do Mar,



Medicine Department of Baixo Vouga Hospital Center


World population aging is associatedwith an increasing

number of people with dementia. This fact should motivate medical

community to improve the appropriate use of drugs that control

the behavioral and psychological symptoms often associated with

dementia. Thus, the aim of this study is to review the proper use of

antipsychotics agents in dementia.


Literature research in PubMed with the MeSH terms

antipsychotic agents, elderly and dementia, of review articles and

Poster presentations / European Geriatric Medicine 7S1 (2016) S29