Older People
Conditions
Keywords
underprescription, START criteria, potential prescriptive omissions
Brief summary
This observational study will determine the prevalence of underprescription in a cohort of elderly patients, recruited at the time of an outpatient geriatric visit, or hospitalized, upon admission to a geriatric ward.
Detailed description
Polypharmacy in older patients is associated with both inappropriate drug prescribing and underprescription or omission of appropriate medications. Potential prescriptive omission (PPO), defined as the underprescription of potentially beneficial drugs, is increasing across all care settings and is associated with adverse clinical outcomes. However, in some cases, PPO may represent a legitimate medical decision. The aim of this study is to investigate the phenomenon of underprescription by differentiating between justified and inappropriate potential prescriptive omissions (PPOs) in elderly patients in both hospital and outpatient settings, using the Screening Tool to Alert to Right Treatment (START) criteria, version 3.
Interventions
None listed
Sponsors
Istituto Nazionale di Ricovero e Cura per Anziani
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Geriatric ward admission or outpatient geriatric appointment * Capacity to provide informed consent by the patient or legal guardian
Exclusion criteria
* Limited life expectancy as measured by the Clinical Frailty Scale (CFS) \>8
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of potential prescription omissions (PPOs) | at baseline and 3 months later | Prevalence of potential prescription omissions (PPOs) will be evaluated by Screening Tool to Alert doctors to Right Treatment (START) criteria version 3 in aged patients enrolled on admission to geriatric departments of participating centers or during geriatric outpatient clinic visits |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Characterisation of the potential prescription omissions (PPOs) | at baseline and 3 months later | The reasons for underprescription will be investigated to differentiate between justified and inappropriate potential prescriptive omissions (PPOs). Patients and/or their family members and/or the general practitioner will be interviewed to assess the potential reasons related to underprescription. |
Countries
Italy
Contacts
Primary ContactAnna Rita Bonfigli
Outcome results
None listed