In concrete, the research carried out by Igurco Healthcare Group (part of the IMQ Group) between 2012 and 2013 with a sample of 688 patients admitted to residential centres, of which 249 corresponded to day-care patients.
As Doctor Iñaki Artaza, specialist in Geriatrics and Gerontology and Healthcare Director at Igurco (and also President of Zahartzaroa) stated, “in September 2012 Stopp/Start prescription criteria were implemented at the Igurco Group residential care homes but not at its day-care centres as these depend on prescriptions from primary care physicians. We thus analysed the trend in the number of pharmaceutical drugs prescribed for each resident/user in the period between October 2012 and March 2013”.
“In this way”, explained the geriatrics specialist, “in just seven months we have managed to go from an average of 6.89 pharmaceutical drugs per elderly patient admitted in residences to an average of 5.85. The reduction of one drug in this context means the cutting down by of their medication by more than 15% – a highly relevant figure”.
On the other hand, “users of the day-care centres — where prescriptions depend on primary care and so Stopp/Start criteria could not be applied as in the residential homes where medication is controlled by geriatric doctors — having a population functionally less dependent than the elderly admitted to residential homes, were prescribed more pharmaceutical drugs than the patients in the residential homes. And not only this, but the levels of medication are maintained over time”.
This is why, the expert argues for “the inclusion of Stopp/Start criteria in normal clinical practice, both in hospital institutions and at primary healthcare level, with the goal of reducing polymedicine and pharmaceutical costs”.
This research was carried out by Igurco professionals Iñaki Artaza, Naiara Fernández, Pilar Sorando, Miren Niño, Marta Mendieta, Rebeca Valera, Juan M. Amurrio, José A.Gardoki and Mitxel Barruetabeña.
Reduction of pharmaceutical costs
In the same vein, another study undertaken at Igurco and presented at the Basque Association of Geriatrics and Gerontology (Zahartzaroa) and the VI Congress of the Navarre Society for Geriatrics and Gerontology, has enabled “reducing the pharmaceutical costs associated with inappropriate prescription, through the application of Stopp/Start criteria with a sample of patients admitted to a long-stay psychogeriatric unit”.
As pointed out by the lead researcher of this study, Doctor Naiara Fernández, geriatric specialist at Igurco, “thanks to the application of these criteria, we have eliminated unnecessary prescriptions and cut back on the average medication administered to each resident, as well as their lines of prescription. Pharmacological revision, applying Stopp/Start criteria and rationalising prescriptions in patients with advanced dementia, has focused on maintaining the comfort of the patient”.
In this way, “we have made savings of 17.19 euros per resident, which annually is a total saving of 206.28 euros. If we multiply this quantity by an average figure of residents in a long-stay psychogeriatric unit, for example of 25 persons, we end up with a pharmacological cost saving of 5,000 euros per year per unit – a very significant figure”.
Besides the enhancement in care indicators (reducing polymedicine) and in healthcare management (pharmaceutical savings), the expert highlighted the benefit of including Stopp/Start criteria “reducing complications linked to the administration of many pharmaceutical drugs, both from the healthcare perspective (less side-effects and interactions) and from the management point of view (reducing the associated indirect cost)”, explained the geriatric specialist.
This research was carried out by Igurco professionals Naiara Fernández, Eneritz Aguirre, IratiSierra Sesumaga, Verónica Martínez, Irune Aurre and Iñaki Artaza.
Stopp/Start criteria (Screening Tool of Older Person’s Prescriptions [STOPP] and Screening Tool to Alert doctors to Right Treatment [START]), using 87 criteria, enable obtaining a list of medicines that should be suspended in the treatment of the elderly patients (STOPP) or initiated (START), depending on their physiopathological situation.