关键词: 老年患者, 衰弱, 潜在不合理用药, 处方精简, STOPPFrail

Abstract: AIM: To measure medication consumption and the prevalence of potentially inappropriate medications (PIMs) during hospitalization and hospital discharge in the geriatric condition of frailty and to provide bases for rational medications use and further deprescribing. METHODS: A clinical data questionnaire, including the basic situation of patients and medications was designed. Charlesson comorbidity index was used to determine the patient's burden and status and the number of medication consumption in the geriatric condition of frailty. The medication consumption was determined by examining Hospital Medication Administration Records. PIMs were defined using STOPPFrail deprescribing criteria and McLeod criteria, whose sensitivity was compared to determine the PIMs independent related factors. RESULTS: This study included 169 patients. The mean age of participants was 83.49±6.73, 42.6% were female. The median number of days spent in hospital was 19 (interquartile range (IQR)12-33). During the first 24 hours of hospitalization, the mean number of individual medications consumed was 9.01 (standard deviation 4.12). Of hospital discharge, the mean number of individual medications consumed was 11.27 (standard deviation 4.57). Over 60% of patients were prescribed at least one PIM at discharge and 7.69% had ≥3 PIMs. Leukotriene antagonists, proton pump inhibitors (PPIs), lipid-lowering medications and diabetic oral agents accounted for major PIMs. Compared with McLeod's criteria, STOPPfrail criteria was a more sensitive tool for 24-hour hospitalization and hospital discharge PIMs screening (t=6.78, P=0.00<0.01; t=10.10, P=0.00<0.01). Full implementation of STOPPFrail recommendations would have resulted in one-in-seven long-term medications being discontinued. CONCLUSION: High levels of medication consumption in the geriatric condition of frailty will result in high burden experienced by patients in the condition of frailty and continued prescribing of futile medications. It is necessary to improve and pay more attention to the safety of medications. The STOPPFrail criteria is highly sensitive, simple and easy to use. Screening for medication consumption in geriatric condition of frailty with STOPPFrail tool will decrease medication burden.

Key words: elderly patient, frailty, potentially inappropriate medications, deprescribing, STOPPFrail