STOPP/START Analysis of Ambulatory Geriatric Patients Attending an Internal Medicine Clinic in Jember, Indonesia

Abstract

Context: Indonesia is one of countries with staggering number of elderly population. This population is at risk having comorbidities, polypharmacy, inappropriate medication, and adverse drug reactions. Aims: This study aimed to determine the prevalence of Potentially Inappropriate Medications (PIM) and Potentially Prescription Omissions (PPO) among ambulatory geriatric patients. Settings and Design: The research was conducted in an internal medicine clinic of a hospital in Jember Regency, East Java, Indonesia using a retrospective, cross– sectional design. Methods and Material: Data were collected consecutively with a targeted sample size of 96 patients during September 2016. Each patient data was traced back for a minimum of three mo period. Analysis of drugs with PIM and PPO was based on criteria of the Screening Tool of Older Person's Prescription (STOPP) and Screening Tool to Alert to Right Treatment (START) version 2. Statistical analysis used: Descriptive statistics were used to report the results. Results: The results showed that a total of 92 PIM events occured in 64 patients (64 %) and were found more in females (66 %), aged 65 yr to 69 yr (70 %) with glimepiride and pioglitazone as the first and second leading drugs causing PIM events. All eight PPOs were in the form of not giving antihypertensive therapy to hypertensive patients according to the START criteria. Conclusions: In conclusion, the PIM figures were large, while the PPO was small and narrowed to one problem. Increasing alertness and caution in administering drug therapy will be very necessary to reduce adverse drug reactions in geriatric patients.