Potentially inadequate prescriptions in polymedicated elderly patients. Community pharmacist’s intervention and follow-up

Background: Potentially inappropriate prescriptions are related with Medication Related Problems and Negative Medication Results, especially in the elderly. Few studies in community pharmacy are available.

Objectives: To improve pharmacotherapy in patients over 65 years receiving more than five medicines. We investigated pharmacotherapy, healthy style, treatment adherence by conducting an open interview with the community pharmacist. Pharmacists´ interventions, patients´ satisfaction and costs were reported.

Patients and methods: A descriptive study in a community pharmacy in Valencia (Spain) was designed. Data were collected in a Microsoft Acces® database and prevalence of potentially inappropriate prescriptions STOPP/START criteria 2014 was evaluated with the Checkthemeds® software.

Results: 88 patients were enroled and 77 patients completed the study (87.5%). Prevalence of potentially inappropriate prescriptions was 33.0% (27.0% STOPP, 7.0% START criteria). A section (duplicities and low evidence treatments) was the most representative. Constipation was very common between the patients. Non-compliant patients (52.0%) and low hydration (77.0%) were important too. 36.0% of potentially inappropriate prescriptions required pharmacist intervention with 14.0% of agreement. 9.0% of potentially inappropriate prescriptions avoided medical intervention with a save of 6,57 € per patient.

Conclusions: The prevalence of STOPP criteria was similar to that other studies. That of minor START criteria. The interview allows to eliminate false, potentially inadequate prescriptions. The systematic and protocolized review improves pharmacotherapy by identifying and intervening in potentially inadequate prescriptions.