The effect of pharmacists on ward rounds measured by the STOPP/START tool in a specialized geriatric unit

K Mulvogue; J A Roberts; I Coombes; N Cottrell; S Kanagarajah; A Smith

doi:10.1111/jcpt.12489

The effect of pharmacists on ward rounds measured by the STOPP/START tool in a specialized geriatric unit

J Clin Pharm Ther. 2017 Apr;42(2):178-184. doi: 10.1111/jcpt.12489. Epub 2016 Dec 16.

Authors

K Mulvogue^{1

2}, J A Roberts^{1

2

3}, I Coombes^{1

2}, N Cottrell², S Kanagarajah⁴, A Smith^{2

5}

Affiliations

¹ Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
² Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, QLD, Australia.
³ Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
⁴ Geriatric Evaluation and Management Unit, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
⁵ School of Pharmacy, University of Otago, Dunedin, New Zealand.

PMID: 27981600
DOI: 10.1111/jcpt.12489

Abstract

What is known and objective: The STOPP/START tool has been validated to assess elderly patients for potentially inappropriate prescribing. This study aimed to assess the effect of inclusion of a pharmacist on a physician-led ward round on potentially inappropriate prescribing in hospitalized elderly patients.

Methods: This was an observational study of prescribing for patients using the STOPP/START tool at three points during hospital stay; admission to hospital, on transfer to the specialized geriatric unit and on discharge from hospital. Data were collected over 4 months pre- and post-introduction of a pharmacist to a physician-led ward round. Demographic and clinical data, including total number of medications and STOPP/START criteria met, were collected. The mean number of STOPP/START criteria at each time-point was compared for pre- and post-introduction of a pharmacist using a Mann-Whitney U-test. The mean number of criteria for each time-point within each group was compared using a paired Student's t-test.

Results and discussion: The demographic characteristics of the participants in the pre- and post-intervention groups were similar. The post-intervention group had numerically less STOPP/START criteria, mean 1·18 (1·37) compared to the pre-intervention group 1·50 (1·41), P = 0·07 at discharge. The pre-intervention group had no significant change in the criteria from admission 1·78 (1·57) to geriatric unit transfer 1·72 (1·54) (P = 0·37); however, there was a significant decrease from geriatric unit transfer 1·72 (1·54) to discharge 1·50 (1·41) (P = 0·02). The post-intervention group had a significant decrease from hospital admission 2·30 (1·91) to geriatric unit transfer 1·59 (1·60) (P < 0·01) and again to discharge 1·18 (1·37) (P < 0·01).

What is new and conclusion: Pharmacist participation on the ward round in a specialized geriatric unit resulted in a numerical improvement in prescribing quality as measured by the STOPP/START tool.

Keywords: aging; clinical pharmacy; elderly; pharmacists; pharmacy practice; physician; prescribing practices.

MeSH terms

Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Health Services for the Aged*
Humans
Inappropriate Prescribing*
Male
Middle Aged
Pharmacists*