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Inappropriate prescribing of antithrombotic therapy in Ethiopian elderly population using updated 2015 STOPP/START criteria: a cross-sectional study.

Getachew H, Bhagavathula AS, Abebe TB, Belachew SA - Clin Interv Aging (2016)

Bottom Line: Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes.IPs were about six times more likely to absent in patients prescribed with antiplatelet only therapy (AOR =6.23, 95% CI, 1.90-20.37) than those receiving any other groups of antithrombotics.Our study may guide further research to reduce high-risk prescription of antithrombotics in the elderly.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

ABSTRACT

Background: Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes. The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients.

Methods: A retrospective cross-sectional, single-center study was conducted at the Gondar University Hospital. A total of 156 hospitalized elderly patients fulfilling the inclusion/exclusion criteria were included in the study. The Screening Tool for Older Person's Prescription/Screening Tool to Alert doctors to Right Treatment criteria version 2 were applied to patients' data to identify the total number of inappropriate prescribing (IPs) including potentially inappropriate medications and potential prescribing omissions.

Results: A total of 70 IPs were identified in 156 patients who met the inclusion criteria. Of these, 36 (51.4%) were identified as potentially inappropriate medications by the Screening Tool for Older Person's Prescription criteria. The prevalence of IP per patient indicated that 58 of the 156 (37.2%) patients were exposed to at least one IP. Of these, 32 (55.2%) had at least one potentially inappropriate medication and 33 (56.9%) had at least one potential prescribing omission. Patients hospitalized due to venous thromboembolism (adjusted odds ratio [AOR] =29.87, 95% confidence interval [CI], 1.26-708.6), stroke (AOR =7.74, 95% CI, 1.27-47.29), or acute coronary syndrome (AOR =13.48, 95% CI, 1.4-129.1) were less likely to be exposed to an IP. An increase in Charlson comorbidity index score was associated with increased IP exposure (AOR =0.60, 95% CI, 0.39-0.945). IPs were about six times more likely to absent in patients prescribed with antiplatelet only therapy (AOR =6.23, 95% CI, 1.90-20.37) than those receiving any other groups of antithrombotics.

Conclusion: IPs are less common in elderly patients primarily admitted due to venous thromboembolism, stroke, and acute coronary syndrome, and those elderly patients prescribed with only antiplatelet. Patients with higher Charlson comorbidity index were, however, associated with increased IPs exposure. Our study may guide further research to reduce high-risk prescription of antithrombotics in the elderly.

No MeSH data available.


Related in: MedlinePlus

Proportion of IP exposure across different types of antithrombotic therapy per patient at Gondar University Hospital, Gondar, Ethiopia, between May 1, 2013 and April 30, 2015.Notes: In this study, anticoagulants identified are warfarin, unfractionated heparin, and low-molecular-weight heparin (enoxaparin); antiplatelets prescribed are aspirin and clopidogrel.Abbreviation: IP, inappropriate prescribing.
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f1-cia-11-819: Proportion of IP exposure across different types of antithrombotic therapy per patient at Gondar University Hospital, Gondar, Ethiopia, between May 1, 2013 and April 30, 2015.Notes: In this study, anticoagulants identified are warfarin, unfractionated heparin, and low-molecular-weight heparin (enoxaparin); antiplatelets prescribed are aspirin and clopidogrel.Abbreviation: IP, inappropriate prescribing.

Mentions: An assessment of the antithrombotic type indicated that a greater proportion of IP per patient was observed when no antithrombotic drugs 12/16 (75%) were prescribed (Figure 1). Based on the primary reason of admission, ten of 15 (66.7%) hospitalized patients due to the primary diagnosis of AF were found to have IP (Figure 2).


Inappropriate prescribing of antithrombotic therapy in Ethiopian elderly population using updated 2015 STOPP/START criteria: a cross-sectional study.

Getachew H, Bhagavathula AS, Abebe TB, Belachew SA - Clin Interv Aging (2016)

Proportion of IP exposure across different types of antithrombotic therapy per patient at Gondar University Hospital, Gondar, Ethiopia, between May 1, 2013 and April 30, 2015.Notes: In this study, anticoagulants identified are warfarin, unfractionated heparin, and low-molecular-weight heparin (enoxaparin); antiplatelets prescribed are aspirin and clopidogrel.Abbreviation: IP, inappropriate prescribing.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4920226&req=5

f1-cia-11-819: Proportion of IP exposure across different types of antithrombotic therapy per patient at Gondar University Hospital, Gondar, Ethiopia, between May 1, 2013 and April 30, 2015.Notes: In this study, anticoagulants identified are warfarin, unfractionated heparin, and low-molecular-weight heparin (enoxaparin); antiplatelets prescribed are aspirin and clopidogrel.Abbreviation: IP, inappropriate prescribing.
Mentions: An assessment of the antithrombotic type indicated that a greater proportion of IP per patient was observed when no antithrombotic drugs 12/16 (75%) were prescribed (Figure 1). Based on the primary reason of admission, ten of 15 (66.7%) hospitalized patients due to the primary diagnosis of AF were found to have IP (Figure 2).

Bottom Line: Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes.IPs were about six times more likely to absent in patients prescribed with antiplatelet only therapy (AOR =6.23, 95% CI, 1.90-20.37) than those receiving any other groups of antithrombotics.Our study may guide further research to reduce high-risk prescription of antithrombotics in the elderly.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

ABSTRACT

Background: Inappropriate use of antiplatelets and anticoagulants among elderly patients increases the risk of adverse outcomes. The aim of this study was to assess the prevalence of inappropriate prescribing of antithrombotic therapy in hospitalized elderly patients.

Methods: A retrospective cross-sectional, single-center study was conducted at the Gondar University Hospital. A total of 156 hospitalized elderly patients fulfilling the inclusion/exclusion criteria were included in the study. The Screening Tool for Older Person's Prescription/Screening Tool to Alert doctors to Right Treatment criteria version 2 were applied to patients' data to identify the total number of inappropriate prescribing (IPs) including potentially inappropriate medications and potential prescribing omissions.

Results: A total of 70 IPs were identified in 156 patients who met the inclusion criteria. Of these, 36 (51.4%) were identified as potentially inappropriate medications by the Screening Tool for Older Person's Prescription criteria. The prevalence of IP per patient indicated that 58 of the 156 (37.2%) patients were exposed to at least one IP. Of these, 32 (55.2%) had at least one potentially inappropriate medication and 33 (56.9%) had at least one potential prescribing omission. Patients hospitalized due to venous thromboembolism (adjusted odds ratio [AOR] =29.87, 95% confidence interval [CI], 1.26-708.6), stroke (AOR =7.74, 95% CI, 1.27-47.29), or acute coronary syndrome (AOR =13.48, 95% CI, 1.4-129.1) were less likely to be exposed to an IP. An increase in Charlson comorbidity index score was associated with increased IP exposure (AOR =0.60, 95% CI, 0.39-0.945). IPs were about six times more likely to absent in patients prescribed with antiplatelet only therapy (AOR =6.23, 95% CI, 1.90-20.37) than those receiving any other groups of antithrombotics.

Conclusion: IPs are less common in elderly patients primarily admitted due to venous thromboembolism, stroke, and acute coronary syndrome, and those elderly patients prescribed with only antiplatelet. Patients with higher Charlson comorbidity index were, however, associated with increased IPs exposure. Our study may guide further research to reduce high-risk prescription of antithrombotics in the elderly.

No MeSH data available.


Related in: MedlinePlus