Op-192 Puma – Potentially Inappropriate Medication In The Elderly – An Analysis Of Primary Health Care In Nursing Home Residents

Niebling W. (Freiburg), Kossow S. (Freiburg), Böhme K. (Freiburg), Loh A. (Freiburg), Beck S. (Freiburg)
Aims and Purpose: Adverse drug events are frequent and costly; they are increased in elderly patients and with inappropriate medication. This study wants to analyse the current extent of inappropriate medication in elderly nursing home residents cared for by primary care physicians.
Methods: 37 GP practices of the quality practice network Freiburg registered 549 patients they cared for in nursing homes. All medication prescribed, age and weight were recorded in the nursing homes. Relevant diagnoses and serum creatinine were collected at the GP practice. Data were analysed using the modified Beers list 2008 and the Prescription-Software RpDoc to assess appropriateness of prescription.
Results: Patients mean age was 83.3 years and 77% were female. On average, 7.75 drugs were prescribed for a patient (ranging from 1 to 29 drugs). The number of diagnosis recorded for a patients averaged at 8.25. Only 5% of patients had two or less diagnosis, up to 30 diagnosis were registered for a patient. Currently, 187 of the 549 records are analysed completely. In 34% of patients, inappropriate prescriptions were found, in 27% this concerned one medication only, in 5% it occurred with 2 different prescriptions, in 1.6% with 3 or more prescriptions. Critical medication prescribed most often is a benzodiazepine: 24% of all 549 patients. 69% of all patients are prescribed psychotropic medication, on average 2 different drugs. Most often, patients have a record of neuroleptic prescription (67% of patients prescribed psychotropic drugs), followed by antidepressants (58%).
Conclusions: Prescribing in the elderly is complex because of multimorbidity, polypharmacy with frequent prescription of psychotropic drugs and organ failure. A software prescription tool can help to minimize inappropriate medication in the primary care setting, either used in the GP practice or directly in Nursing homes.
PUMA – potentially inappropriate medication in the elderly – an analysis of primary health care in nursing home residents