Objective: LESS-CHRON (List of Evidence-Based Deprescribing for Chronic Patients) and STOPPFrail (Screening Tool of Older Persons' Prescriptions in Frail adults with limited life expectancy) are criterion-based deprescribing tools. This study aimed to identify the prevalence of potentially inappropriate medications (PIMs) with these tools in an outpatient, polymedicated, older population with multimorbidity.
Design: Single-center cross-sectional observational study.
Setting And Participants: PIMs and criteria subject to deprescribing identified by each tool were collected in patients who were being followed up on outpatient internal medicine consultation.
Methods: PIMs were identified by STOPPFrail and LESS-CHRON criteria reviewing medical histories and pharmacologic treatments of the patients in the electronic health card system. Sociodemographic, clinical, and pharmacologic variables were recorded. A correlation analysis between treatment tools and clinical values was performed using the nonparametric Spearman rho correlation.
Results: Eighty-three patients with a median of 14.4 (interquartile range 12-17) prescribed drugs were included. The total number of PIMs identified with LESS-CHRON was 158 vs 127 with STOPPFrail. Eight of the 27 criteria (29.6%) for LESS-CHRON and 15 of the 25 for STOPPFrail were found to be not applicable. A significant correlation was obtained for both tools with the number of prescribed drugs at the time of inclusion. The Profund, Barthel, and Frail-VIG index only showed a significant correlation with LESS-CHRON.
Conclusion And Implications: Both tools have shown the capacity to identify PIMs that can be deprescribed in the population studied. However, LESS-CHRON appears to have a greater detection potential in the subgroup of patients analyzed. STOPPFrail brings a certain complementarity in other areas of therapy not covered by LESS-CHRON.
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http://dx.doi.org/10.1016/j.jamda.2022.12.013 | DOI Listing |
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Saarland University, Institute of Sports and Preventive Medicine, Campus Geb B8 2, Saarbrücken, Germany.
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iMed.ULisboa-Research Institute for Medicines, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal.
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Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy.
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