Prescribing omissions among elderly Brazilian patients at their hospital admission and discharge: cross-sectional study

Abstract

Background Potentially inappropriate prescribing for older people has become a global concern, although few researchers have analyzed potential prescribing omissions for this population. Objective This study aimed to compare the frequency of potential prescribing omissions for elderly patients at their admission to and discharge from a university hospital in northeast Brazil, using the validated and adapted Brazilian START criteria. Setting A university hospital in northeast Brazil. Methods This cross-sectional study examined data from patients who were ≥ 60 years old when they were admitted for > 24 h to a northeastern Brazil teaching hospital during June-December 2016. Main outcome measure Frequency of potential prescribing omissions for elderly patients at their admission to and discharge. Results Data from 227 patients were included. The mean patient age was 71 ± 8.23 years. The patients included 131 women (57.7%), and 176 patients (77.5%) presented with a Charlson Comorbidity Index of ≥ 3. Based on the START criteria, the frequency of potential prescribing omissions was 44.1% (100/227) at the admission and decreased to 39.6% (90/227) at the discharge. The most common potential omissions at the admission were beta-blockers in cases of stable chronic angina, and angiotensin converting enzyme inhibitors or angiotensin receptor blockers in cases of diabetic nephropathy or renal dysfunction. Conclusion The prevalence of potential prescribing omissions among elderly patients remained relatively high at their discharge from a northeastern Brazilian university hospital. The START criteria could be a useful tool to optimize the clinical management of the elderly.

Keywords: Admission; Brazil; Hospital discharge; Prescribing habits; Prescribing omissions.