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POTENTIALLY INAPPROPRIATE PRESCRIBING IN ELDERLY PATIENTS ACROSS HEALTHCARE SETTINGS: APPLICATION OF STOPP/START VERSION 2 CRITERIA

KOVAČEVIĆ MILENA 1*, CATIĆ-ĐORĐEVIĆ ALEKSANDRA 2, JOVANOVIĆ MARIJA 1, ĆULAFIĆ MILICA 1, STEFANOVIĆ NIKOLA 2, MITIĆ BRANKA 3,4, VUČIĆEVIĆ KATARINA 1, VEZMAR KOVAČEVIĆ SANDRA 1, VELIČKOVIĆ-RADOVANOVIĆ RADMILA 3,4, MILJKOVIĆ BRANISLAVA 1

1University of Belgrade - Faculty of Pharmacy, Department of Pharmacokinetics and Clinical Pharmacy, Vojvode Stepe 450, 11221, Belgrade, Republic of Serbia
2 University of Niš - Faculty of Medicine, Department of Pharmacy, Dr Zorana Đinđića 81 Blvd., 18000, Niš, Republic of Serbia
3 University of Niš - Faculty of Medicine, Department of Pharmacology with Toxicology, Dr Zorana Đinđića 81 Blvd., 18000, Niš, Republic of Serbia
4 University Clinical Center Niš, Clinic of Nephrology, Dr Zorana Đinđića 48 Blvd., 18000, Niš, Republic of Serbia

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The increasing number of multimorbid patients with complex drug regimens leads to a higher prevalence of inappropriate prescribing with severe health issues and socioeconomic outcomes. The study aimed to compare the prevalence, types and factors associated with the STOPP/START version 2 criteria across the inpatient, outpatient and community settings. An observational study comprised 240 inpatients, 200 outpatients and 440 patients attending community pharmacies. At least one STOPP criterion was present in 49 - 74.2% of patients, and the START prevalence ranged from 39.5 - 53.3%. The extent of inappropriate prescribing was the lowest in the outpatients, followed by the community-dwelling patients, and the highest among the inpatients. The most common STOPP criteria were drug indication (35.6%), followed by fall-risk drugs (32.3%), central nervous system (28.3%), and cardiovascular system (11.7%). In almost one-third of outpatients (31.5%) and community-dwelling patients (31.8%), up to 41.3% of inpatients, we found underprescribing cardiovascular system drugs. The study revealed a high prevalence of STOPP/START v2 criteria across the inpatient, outpatient and community settings. The highest frequency of inappropriate prescribing was observed during hospital stays when morbid and therapy states in elderly patients become even more challenging. However, the observed increase in the prevalence of inappropriate prescribing during hospitalisation indicates the opportunity to tailor the patient’s therapy in timely collaboration with specialists using up-to-date clinical prescribing tools.