4CPS-218 Analysis of potentially inappropriate medication prescription in patients admitted to an emergency department

<h3>Background and Importance</h3> A recent study published in August 2023 establishes the prevalence of potentially inappropriate medication (PIM) in 37% of patients &lt;65 years of age worldwide. 57% of patients who have PIM suffer medication-related adverse effects, +24% than those who do not have PIM. The pharmacotherapeutic review of these patients is a challenge for health systems and hospital pharmacists. <h3>Aim and Objectives</h3> Analyse the results of the implementation of a programme to detect PIM in an Emergency Department (ED) and describe the pharmacotherapeutic groups most frequently involved. <h3>Material and Methods</h3> Multicentre, prospective study, lasting 8 months (November 2022 to June 2023). All patients aged 70 years or older, polypharmacy (five chronic drugs or more) admitted to the ED were included in the study. Those with palliative sedation and those institutionalised were excluded. Data were obtained from the clinical history, the assisted electronic prescription program, the electronic prescription software and the interview with the patient and/or caregiver. PIM prescribed was reviewed following the Beers and Stop/Start criteria. The variables collected were: age, sex, number of chronic medications, number of drugs and pharmacotherapeutic groups considered as PIM. Statistical analysis was performed with the SPSS program using Student’s t-test for independent samples. P&lt;0.05 was taken as a statistically significant relationship. <h3>Results</h3> 198 patients were included, with a median age of 80 years (70–98). A total of 2,671 chronic medications were reviewed, with a median of 14 medications/patient (range: 5–21). 130 PIM were detected in 45% of the patients (average of 1,2 PIM for these patients). 81% of patients were prescribed only one PIM, 20% were prescribed two, 8% were prescribed three, and only 1% were prescribed four. The drugs most frequently involved as PIM were: sedative-hypnotics (93%), antipsychotics (8%), urinary antispasmodics (5%) and potassium-sparing diuretics (5%). When comparing the number of chronic medications taken by patients without and with prescribed PIM, statistically significant differences were found (10,03±13,23 vs 11,80±12,77 respectively, p&lt;0.05). <h3>Conclusion and Relevance</h3> Almost half of patients over 70 years of age who visit the ED are on treatment with PIM. Almost all patients analysed were taking sedative or hypnotic medication. We can conclude that the greater the number of chronic drugs prescribed, the greater the probability of presenting PIM. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest