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

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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.
Methods: 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.
Results: 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.
Conclusions: 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
Hospital.
P-795
Falls of older patients: the influence of drugs
M.M. Moraes1, M.A. Soares2, J. Gorjao Clara3. 1Faculty of Pharmacy of
Lisbon University, Geriatric University Unit, Faculty of Medicine of Lisbon
University, 2Faculty of Pharmacy of Lisbon University, 3Geriatric
University Unit, Faculty of Medicine of Lisbon University
Introduction: 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.
Goals: To characterize the pharmacological profile of older patients
(≥65 years old) with falls.
Methods: Cross-sectional study. Data were collected during their 1st
attendance in geriatric medicine.
Results: 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.
Conclusions: 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.
P-796
Clinical and pharmacological correlations in geriatrics
A. Mota, C. Eira, R. Silvério, A. Monteiro. Internal Medicine Department –
Centro Hospitalar Tondela-Viseu, E.P.E.
Introduction: 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 (≤3;≥4), fall/fracture history,
Morse scale (<51;≥51), total (≤7;≥8) and potentially inappropriate (PI:
0;≥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.
P-797
Inappropriate prescription of PPI’ s and statins and their
contribution to poly-medication in elderly
A. Mouzon1, V. Mignon2, B. Hamoir2, D. Schoevaerdts2, A. Spinewine1,
C. Swine2. Université catholique de Louvain CHU UCL Namur, Belgium;
1Clinical Pharmacy, 2Geriatric Medicine Departments
Objectives: 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.
Methods: 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’s.
Results: 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).
Conclusions: PPI’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.
P-798
Antipsychotics agents in dementia
C. Neves1, P. Almeida2. 1Unidade de Saúde Familiar do Mar, 2Internal
Medicine Department of Baixo Vouga Hospital Center
Introduction: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.
Methods: 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–S259 S239