Retrospective case review analysis was conducted on 198 patients aged over 65 who were discharged from the HCOP directorate in a large teaching hospital in England after 23 December 2013. Records were assessed against the STOPP/START criteria using a custom designed data collection
form at both admission and discharge. In addition, dates of admission and discharge, medicines, co-morbidities, date of birth and reason for admission were recorded. Data was collected by four researchers with initial cases being reviewed by all data collectors to ensure consistency of data collection. Any queries were referred to the HCOP clinical team for clarification. Data were analysed using IBM SPSS and Microsoft Excel. This audit was conducted with approval of the hosting trust, ethical approval was not required. The mean age of patients in the audit was 84 year (SD 7.3) BAY 57-1293 clinical trial and included 73 males and 125 females. The mean duration of stay was 10.1 days (SD 6.3), the mean number of comorbidities 6.3 (SD 2.9) and mean number of medicines on admission 7.63 (SD 3.3). Of the 198 patients reviewed 121 (61%) had violations of the STOPP/START criteria at admission and 103 (52%) at discharge. Considering
inappropriate prescriptions (STOPP), 63 (32%) patients had at least one STOPP violation on admission, Erastin mouse which was reduced to 46 (23%) patients at the point of discharge. 69 (35%) patients were admitted with prescribing omission as defined by START which increased to 71 (36%) at discharge. The researchers identified that 9 patients were palliative and therefore the START criteria were considered inappropriate. When these patients are excluded 64 (34%) patients had START violations at admission and 65 (34%) at discharge. The most prevalent STOPP violations on admission were duplication within drug classes, triclocarban drugs that affect patients prone to falls, inappropriate use of central nervous system and psychotropic drugs, cardiovascular drugs and opiate drugs. This audit has confirmed that secondary care HCOP clinicians further optimise prescribing against
a primary care baseline. Compared to the previous audit in 2012 these data suggest that primary care prescribing has improved locally over the previous 2 years. As a consequence it has not been clear from this audit whether the STOPP/START training has had significant impact as a result of the significant baseline improvements. 1. Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Persons’; Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment): Consensus Validation. Int J Clin Pharmacol Ther 2008; 46(2): 72–83 P. Czarniaka, J. Hughesa, B. Sunderlanda, R. Parsonsa, L. Bintb aCurtin University, Perth, Western Australia, Australia, bPrincess Margaret Hospital, Perth, Western Australia, Australia A randomly selected 12 month sample of off-label and unlicensed prescribing in a paediatric hospital in Australia was conducted. Overall 28.