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Detection of potentially inappropriate prescribing in older patients with the GheOP³S-tool: completeness and clinical relevance

CELINE KYMPERS (UGent) , Eline Tommelein (UGent) , Ellen Van Leeuwen (UGent) , Koen Boussery (UGent) , Mirko Petrovic (UGent) and Annemie Somers (UGent)
(2019) ACTA CLINICA BELGICA. 74(2). p.126-136
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Abstract
Objectives: The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP(3)S-) tool was recently developed as an explicit screening method to detect Potentially Inappropriate Prescribing (PIP) in the community pharmacy. We aimed to validate the GheOP(3)S-tool as an effective screening method for PIP. Methods: All patients admitted to the acute geriatric ward of the Sint-Vincentius hospital (Belgium) were consecutively screened for inclusion (>= 70 years,>= 5 drugs chronically). PIP prevalence was evaluated by applying the GheOP(3)S-tool on the complete medication history. For each PIP-item, clinical relevance of the detected item, relevance of proposed alternative and subsequent acceptance by the treating geriatrician and a general practitioner were evaluated. Additionally, contribution to the current admission and preventability was assessed by the geriatrician. The completeness of a PIP-screening with the GheOP(3)S-tool was evaluated through comparison with the adapted Medication Appropriateness Index (aMAI). Results: We detected 250 GheOP(3)S-items in 57 of 60 included patients (95%) (median: four PIP-items per patient; IQR: 3-5). Both the geriatrician and the general practitioners scored the clinical relevance of the detected items 'serious' or 'significant' in over 70% of cases. Proposed alternative treatment plans were accepted for 79% of the PIP-items (n = 198). The aMAI detected 536 items, of which 145 were also detected by the GheOP(3)S-tool. A total of 119 PIP-items were additionally detected by the GheOP(3)S-tool. Conclusion: The clinical relevance of the PIP-items detected with the GheOP(3)S-tool is high, likewise the acceptance rate of proposed alternatives.
Keywords
GheOP(3)S, aMAI, PIP, polypharmacy, DRUG-RELATED PROBLEMS, ELDERLY-PATIENTS, BEERS CRITERIA, MEDICATION USE, HOSPITAL ADMISSIONS, PHARMACIST, RISK, STOPP, APPROPRIATENESS, DOCTORS

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Chicago
KYMPERS, CELINE, Eline Tommelein, Ellen Van Leeuwen, Koen Boussery, Mirko Petrovic, and Annemie Somers. 2019. “Detection of Potentially Inappropriate Prescribing in Older Patients with the GheOP3S-tool: Completeness and Clinical Relevance.” Acta Clinica Belgica 74 (2): 126–136.
APA
KYMPERS, C., Tommelein, E., Van Leeuwen, E., Boussery, K., Petrovic, M., & Somers, A. (2019). Detection of potentially inappropriate prescribing in older patients with the GheOP3S-tool: completeness and clinical relevance. ACTA CLINICA BELGICA, 74(2), 126–136.
Vancouver
1.
KYMPERS C, Tommelein E, Van Leeuwen E, Boussery K, Petrovic M, Somers A. Detection of potentially inappropriate prescribing in older patients with the GheOP3S-tool: completeness and clinical relevance. ACTA CLINICA BELGICA. 2019;74(2):126–36.
MLA
KYMPERS, CELINE et al. “Detection of Potentially Inappropriate Prescribing in Older Patients with the GheOP3S-tool: Completeness and Clinical Relevance.” ACTA CLINICA BELGICA 74.2 (2019): 126–136. Print.
@article{8594095,
  abstract     = {Objectives: The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP(3)S-) tool was recently developed as an explicit screening method to detect Potentially Inappropriate Prescribing (PIP) in the community pharmacy. We aimed to validate the GheOP(3)S-tool as an effective screening method for PIP.
Methods: All patients admitted to the acute geriatric ward of the Sint-Vincentius hospital (Belgium) were consecutively screened for inclusion ({\textrangle}= 70 years,{\textrangle}= 5 drugs chronically). PIP prevalence was evaluated by applying the GheOP(3)S-tool on the complete medication history. For each PIP-item, clinical relevance of the detected item, relevance of proposed alternative and subsequent acceptance by the treating geriatrician and a general practitioner were evaluated. Additionally, contribution to the current admission and preventability was assessed by the geriatrician. The completeness of a PIP-screening with the GheOP(3)S-tool was evaluated through comparison with the adapted Medication Appropriateness Index (aMAI).
Results: We detected 250 GheOP(3)S-items in 57 of 60 included patients (95\%) (median: four PIP-items per patient; IQR: 3-5). Both the geriatrician and the general practitioners scored the clinical relevance of the detected items 'serious' or 'significant' in over 70\% of cases. Proposed alternative treatment plans were accepted for 79\% of the PIP-items (n = 198). The aMAI detected 536 items, of which 145 were also detected by the GheOP(3)S-tool. A total of 119 PIP-items were additionally detected by the GheOP(3)S-tool.
Conclusion: The clinical relevance of the PIP-items detected with the GheOP(3)S-tool is high, likewise the acceptance rate of proposed alternatives.},
  author       = {KYMPERS, CELINE and Tommelein, Eline and Van Leeuwen, Ellen and Boussery, Koen and Petrovic, Mirko and Somers, Annemie},
  issn         = {1784-3286},
  journal      = {ACTA CLINICA BELGICA},
  language     = {eng},
  number       = {2},
  pages        = {126--136},
  title        = {Detection of potentially inappropriate prescribing in older patients with the GheOP{\textthreesuperior}S-tool: completeness and clinical relevance},
  url          = {http://dx.doi.org/10.1080/17843286.2019.1568353},
  volume       = {74},
  year         = {2019},
}

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