Omission of cardiovascular risk modifying drugs in elderly patients admitted to a stroke unit

Abstract

Goals: To quantify and characterize prescribing omissions of cardiovascular risk management therapy using START (Screening Tool to Alert Doctors to the Right Treatment) criteria. Type of Study: Descriptive observational study Local: Stroke Unity of the Centro Hospitalar da Cova da Beira (CHCB). Population: Elderly patients (age =65 years) admitted with acute cardiovascular disease. Methods:Medical records from elderly patients admitted between October and December 2009 were consulted and the START criteria applied to data on prescribed medicines. Results: Our study included 56 elderly in-patients. We detected 63 prescribing omissions in 69,8% of these elderly (average of 1,19 omissions by patient), from which 74,5% (n=38) were corrected. Prescribing omissions were also detected in 80,9% of patients taking 5 or more medications simultaneously. In 10 patients, 13 omissions detected at hospital admission were not corrected and in 3 patients, 3 new prescribing omissions were detected. Conclusions: The prevalence of omission of evidence-based appropriate drug therapy in cardiac acutely-ill hospitalized elderly patients is high. START criteria are a useful instrument to validate essential drug therapy, particularly in relation to cardiovascular disease prevention.