81 Evaluation of screening tools to assess inappropriate medication use in the elderly

Thursday, May 24, 2012
Stephanie M. Callinan, BS1 and Timothy Reilly, Pharm.D, BCPS, CGP, FASCP2
1Rutgers, the State University of New Jersey, Piscataway, NJ
2University Medical Center at Princeton, Princeton, NJ

Objectives: Due to altered pharmacokinetic and pharmacodynamic parameters, elderly patients have an increased risk of experiencing an adverse drug reaction (ADR), and these reactions are a common cause of hospitalizations in this age group. The Beers criteria and the Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria list medications that have an increased risk of causing adverse events in the geriatric population. The purpose of this study is to determine which criteria are better predictors of adverse events for patients on the Acute Care for the Elderly (ACE) Unit at our institution.

Methods: Exempt status was obtained from the appropriate institutional review boards for this retrospective chart review. Inclusion criteria consist of patients greater than 65 years of age, taking at least 1 drug before admission, and were admitted to the ACE unit at our institution between the dates of January 20 and May 20, 2011. The two primary endpoints of this study were length of stay (LOS) and number of ADRs. Statistical differences were detected using a Student's t-test and Mann Whitney test.

Results: There were 340 patients who met the criteria, 143 (41.1%) of whom were prescribed a Beers criteria drug before or during admission. The most commonly prescribed Beers criteria drug was ferrous sulfate (>325mg/day). Subjects taking Beers drugs had a significantly longer mean LOS (8.34 days vs 6.22 days, p=0.006) and an increased likelihood of experiencing an ADR (OR=1.83; CI 1.10, 3.05). An analysis of patients prescribed STOPP criteria drugs is being conducted using the above methods.

Conclusions: Patients prescribed Beers criteria drugs were observed to have an increased LOS and likelihood of experiencing an ADR. A continuing evaluation of STOPP criteria drugs is in progress and will be completed by April 2012.