Abstract Body

Background and purpose

Potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are frequently described in older people. However, the medical relevance of PIMs/PPOs are seldom reported. Our purpose was to evaluate the medical relevance of STOPP/START criteria in older patients in a Swedish primary care health center.

Methods

In 123 consecutive patients (≥65 years), PIMs and PPOs according to the STOPP/START v.2 (80 PIMs and 34 PPOs) were identified by a specialist in family medicine. Each PIM/PPO, as well as the overall drug treatment, was then assessed from a medical perspective. Individual characteristics of the patient such as morbidity and life expectancy were considered.

Results

A total of 82 (67%) patients had ≥1 PIMs/PPOs according to STOPP/START, with 125 PIMs and 54 PPOs identified in 59 (48%) and 49 (40%) patients, respectively. The medical assessment revealed that 33 PIMs (26%) were reasonable drug treatment, whereas 86 PIMs (69%) and 54 PPOs (100%) could be considered in the long term to improve the drug treatment, and 6 PIMs (5%) could be acted upon directly. Among patients with ≥1 PIMs/PPOs, the overall drug treatment was assessed as reasonable in 42 cases (51%), whereas 30 (37%) could benefit from some action in the long term and 10 (12%) could be acted upon directly.

Conclusions

When a primary care physician perspective is applied at the individual level, there was no medical reason to change the drug treatment in every other patient with at least one PIMs/PPOs.