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Long‐Term Outcomes of Medication Intervention Using the Screening Tool of Older Persons Potentially Inappropriate Prescriptions Screening Tool to Alert Doctors to Right Treatment Criteria
Author(s) -
Frankenthal Dvora,
Israeli Avi,
Caraco Yoseph,
Lerman Yaffa,
Kalendaryev Edward,
ZandmanGoddard Gisele,
Lerman Yehuda
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14570
Subject(s) - medicine , medical prescription , randomized controlled trial , intervention (counseling) , prospective cohort study , cohort , retrospective cohort study , physical therapy , emergency medicine , pediatrics , psychiatry , pharmacology
Objectives To compare 24‐month outcomes of participants of a prospective randomized controlled trial ( RCT ) assigned to undergo a medication intervention of orally communicated recommendations based on Screening Tool of Older Persons potentially inappropriate Prescriptions ( STOPP ) and Screening Tool to Alert Doctors to Right Treatment ( START ) (intervention group) with outcomes of those assigned to undergo written medication review (control group). Design Retrospective cohort study. Setting Chronic care geriatric facility. Participants Of 359 participants from a prospective RCT conducted between April 2012 and September 2013, 306 were evaluable for another 12‐month follow‐up. Measurements Outcomes at 24‐month follow‐up included quality of prescribing (assessed according to STOPP / START ), hospitalizations, falls, costs of medications, and all‐cause mortality. Outcomes were compared with those reported at the beginning (baseline) and end (12‐month follow‐up) of the RCT . Results There was a significant rise in potentially inappropriate prescriptions ( PIP s) ( P = .01) and potentially prescriptions omissions ( PPO s) ( P < .001) in the intervention group between 12 and 24 months, although the prevalence of PIP s was significantly lower in the intervention group (33.3%) than the control group (48.4%) at 24‐month follow‐up ( P = .02). Costs of medications were significantly lower in the intervention group than the control group ( P < .001) at 24‐month follow‐up. The average number of falls in both groups dropped significantly between baseline and study closure ( P = .04 and P = .008, respectively). There was no significant difference in hospitalizations and mortality between the two groups at 24‐month follow‐up. Conclusion The effect of an orally communicated medication intervention with the STOPP / START criteria on falls was maintained over time. Direct communication between pharmacists and prescribing physicians is more efficient than written medication review and is recommended every 6 months in geriatric facilities.