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

ABSTRACT

Objectives: The Ghent Older People’s Prescriptions community Pharmacy Screening (GheOP³S-) tool was recently developed as an explicit screening method to detect Potentially Inappropriate Prescribing (PIP) in the community pharmacy. We aimed to validate the GheOP³S-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 GheOP³S-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 GheOP³S-tool was evaluated through comparison with the adapted Medication Appropriateness Index (aMAI).Results: We detected 250 GheOP³S-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 GheOP³S-tool. A total of 119 PIP-items were additionally detected by the GheOP³S-tool.Conclusion: The clinical relevance of the PIP-items detected with the GheOP³S-tool is high, likewise the acceptance rate of proposed alternatives.

KEYWORDS:

• GheOP³S
• aMAI
• PIP
• polypharmacy

Conflicts of interest

The authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author Contributions

CK en ET conceptualized and designed the study, carried out the statistical analyses and interpretation of data, drafted the initial manuscript, and approved the final manuscript as submitted. EVL retrospectively evaluated the severity of the detected PIP-items and approved the final manuscript as submitted. KB and MP critically reviewed the manuscript and approved the final version as submitted. AS analyzed and interpreted the data, critically reviewed the manuscript, and approved the final manuscript as submitted.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

No funding was obtained for this research.