Overuse and underuse of aspirin according to STOPP and START in frail older persons
(2011) XIVèmes Journées d’Automne dela SBGG — Location: Liège, Belgium (21.October.2011)
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- Background & Objective. STOPP and START criteria are useful tools to detect inappropriate use of medications in elderly people. Six STOPP and three START criteria concern aspirin use. The aim of this study is to describe aspirin misuse according to STOPP and START criteria in frail older patients and related hospital admission. Methods. Prospective collection upon hospital admission of geriatric, medical and pharmacological information in consecutive older persons (≥ 75 years) with frailty features (ISAR ≥ 2/6) admitted for acute illness. Using the STOPP and START criteria, a pharmacist and a geriatrician independently detected events of inappropriate medication (IM) and of prescribing omission (PO) concerning the pharmacological regimen at home , and determined whether the hospital admission was related to IM or PO. Results. 302 frail older persons (84±5 years; ♀ 63%; ISAR 3.5±1) were included. IM was present in 48 % of them.. Overuse of aspirin concerned 35 of the 210 IM events, i.e "aspirin at dose > 150 mg/day" (n=25; 71%); "aspirin with no history of coronary, cerebral or peripheral vascular symptoms or occlusive event (n=7; 20%) "; "aspirin with a past history of peptic ulcer disease without gastric protection" (n=2); “use of aspirin and warfarin in combination without gastric protection" (n=1); “aspirin to treat dizziness not clearly attributable to cerebrovascular disease (n=1). One patient cumulated 2 STOPP criteria for aspirin. PO was observed in 63 % of the frail older persons. Underuse of aspirin concerned 77 of the 362 PO events (21%), i.e. (non-use of) "aspirin in secondary prevention [i.e. in case of documented history of atherosclerotic coronary, cerebral or peripheral vascular disease in patients with sinus rhythm] (n=41; 53%), in "diabetes mellitus with coexisting major cardiovascular risk factors" (n=33; 43%), or in "chronic atrial fibrillation, where warfarin is contraindicated" (n=3).
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Dalleur, O., Spinewine, A., Henrard, S., Speybroeck, N., & Boland, B. (2011). Overuse and underuse of aspirin according to STOPP and START in frail older persons. Geriatrie et Psychologie Neuropsychiatrie du Vieillissement, 9(3), 320. https://hdl.handle.net/2078.5/216240 (Original work published 2011)