Identification of inappropriate prescribing in a Brazilian nursing home using STOPP/START screening tools and the Beers' Criteria

The objective of this study was to determine the prevalence of Potentially Inappropriate Medication (PIM) use and associated factors, as well as the prevalence of Prescribing Omissions (PO). A cross-sectional study was conducted in a philanthropic Brazilian nursing home involving 46 individuals aged 60 years or older. The following information was collected from medical records and drug prescriptions: gender, age, health conditions and drugs used in the past thirty days. PIM and PO were identified according to the Beers' Criteria and the STOPP/START screening tools. Over one third (37%) of the population used at least one PIM according to the Beers' Criteria (n=17) and 60.9% according to the STOPP tool. A significant association was found between polypharmacy (use of five or more drugs) and use of PIM according to the Beers' Criteria, but not according to the STOPP. Eight residents (17.4%) were exposed to eight PO. This study allowed the diagnosis of a concerning drug utilization profile with use of a high number of PIMs. Thus, there is an evident need to implement strategies for improving geriatric prescription.

本研究旨在明确潜在不适当用药（Potentially Inappropriate Medication，PIM）的使用现况及其相关影响因素，同时调研处方遗漏（Prescribing Omissions，PO）的发生频率。本研究针对巴西一家慈善性养老院开展横断面研究，共纳入46名60岁及以上的老年人。研究人员从医疗记录与药物处方中收集如下信息：性别、年龄、健康状况及近30日内使用的药物。依据Beer标准（Beers' Criteria）与STOPP/START筛查工具（STOPP/START screening tools），分别识别潜在不适当用药与处方遗漏案例。结果显示，按照Beer标准，超过三分之一（37%）的研究对象存在至少1种潜在不适当用药（n=17）；而采用STOPP工具评估的比例则达60.9%。研究发现，多重用药（同时使用5种及以上药物）与依据Beer标准判定的潜在不适当用药存在显著关联，但该关联未在STOPP工具的评估结果中体现。另有8名养老院入住者（占比17.4%）存在8项处方遗漏情况。本研究揭示了当前老年用药现状存在显著隐患，潜在不适当用药比例较高。因此，亟需制定相关策略以优化老年患者的处方开具工作。