slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Measuring and Evaluating Indicators of Appropriate Prescribing in Older Populations Cahir C., Teeling M., Feely J, Byrn PowerPoint Presentation
Download Presentation
Measuring and Evaluating Indicators of Appropriate Prescribing in Older Populations Cahir C., Teeling M., Feely J, Byrn

Loading in 2 Seconds...

play fullscreen
1 / 13

Measuring and Evaluating Indicators of Appropriate Prescribing in Older Populations Cahir C., Teeling M., Feely J, Byrn - PowerPoint PPT Presentation


  • 177 Views
  • Uploaded on

Measuring and Evaluating Indicators of Appropriate Prescribing in Older Populations Cahir C., Teeling M., Feely J, Byrne S., Fahey T., Bennett K. Caitriona Cahir HRB PhD Scholar Division of Population Health Sciences RCSI. Structure of presentation. Brief background to study.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Measuring and Evaluating Indicators of Appropriate Prescribing in Older Populations Cahir C., Teeling M., Feely J, Byrn' - vernon


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Measuring and Evaluating Indicators of Appropriate Prescribing in Older PopulationsCahir C., Teeling M., Feely J, Byrne S., Fahey T., Bennett K.

Caitriona CahirHRB PhD ScholarDivision of Population Health SciencesRCSI

structure of presentation
Structure of presentation
  • Brief background to study.
  • Outline of study objectives.
  • Methods.
  • Results.
  • Items for discussion and further research.
appropriate prescribing in older people
Appropriate prescribing in older people
  • “Good prescribing” should encompass the appropriate choice of medicine not only from the perspective of the physician but also that of the patient, while at the same time aiming to maximise effectiveness, minimise risk and minimise cost (Barber, 1995).
  • Appropriateness of prescribing – assessed by process or outcome measures that are explicit (criterion based) or implicit (judgment based) (Spinewine et al., 2007).
appropriate prescribing in older people4
Appropriate prescribing in older people
  • Explicit and implicit measures -US Beers criteria, DUR, ACOVE, IPET, MAI.
  • Beers criteria- US and Canadian studies- 14% to 37%. European cross-sectional study -19.8%.
  • Process measures should have links to health outcomes. Evidence is mixed and contradictory.
  • UCC STOPP/START screening tool of older person’s potentially inappropriate prescriptions (Gallagher et al., 2007).
objectives
Objectives
  • Estimate the prevalence of potentially inappropriate prescribing (PIM) in older populations in Ireland in 2007 using STOPP criteria.
  • Investigate the association between PIM and gender and age.
  • Establish the associated cost.
  • Relationship between the no. of medications taken and PIM.
methods
Methods
  • Retrospective population based cohort study (aged ≥70 years) using the HSE-PCRS (n=334,452).
  • Thirty STOPP indicators–Cardiovascular (7), CNS (9),Gastrointestinal (2), Respiratory (2), Muscoskeletal (2), Urogential (2), Endocrine (1) and duplicate classes of medicines (5).
  • Logistic regression- gender and age.
results n 334 452
Results(n=334,452)
  • 27% (n=91,740) of the population aged ≥ 70 years were prescribed one PIM.
  • 10% (n=32,877) were prescribed two.
  • 3% (n=9,665) were prescribed three.
  • 0.71% (n=2,374) were prescribed four.
results
Results
  • Total NIC of STOPP medication in 2007 was €39,204,062. Total expenditure was €47,730,089.
  • 9% were recipients of ≥ 5 medications per month and a PIM.
stopp adjusted cost analysis 2007 nic 39 204 062
STOPP Adjusted Cost Analysis 2007 (NIC= €39,204,062 )

* Adjusted for claimants receiving the same medication per more than one criteria

items for discussion and further research
Items for discussion and further research
  • PPIs- further analysis
    • Co-prescriptions.
    • Duration of PPI prescribing and dosage.
  • Duplicates
    • Two concurrent NSAIDs (2.09%) –Diclofenac with glucosamine or nimesulide.
    • Two concurrent opioids (1.13%)- Tramadol with codeine and morphine.
items for discussion and further research12
Items for discussion and further research
  • Comparison- Beers versus STOPP.
  • Linkage studies- to assess health outcomes

and explore reasons behind prescribing patterns.

  • Predictive risk modelling.
  • Develop practical prescribing guidelines and clinical decision support systems.