Abstract
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.
Keywords
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Article info
Publication history
Published online: January 03, 2023
Accepted:
December 11,
2022
Received in revised form:
November 13,
2022
Received:
August 8,
2022
Publication stage
In Press Corrected ProofFootnotes
Funding sources: MMT received financial support from the Subprograma Río Hortega, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Spain (CM21/00115).
The authors declare no conflicts of interest.
Identification
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© 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
