European Geriatric Medicine
Potentially inappropriate medication in palliative care patients
according to STOPP‑Frail criteria
· Núria Molist‑Brunet
· Joan Espaulella‑Panicot
· Javier González‑Bueno
· Jordi Amblàs‑Novellas
· Carles Codina‑Jané
Received: 15 January 2018 / Accepted: 24 May 2018
© European Geriatric Medicine Society 2018
Background Potentially inappropriate medications (PIMs) are common in palliative care patients, but no speciﬁc tools have
been used to determine these PIMs.
Objective To evaluate the prevalence of PIMs according to speciﬁc tool ‘STOPP-Frail’, related factors with its existence
and clinical consequences.
Methods This is a post hoc analysis from a 10-month prospective cross-sectional study. Upon hospital admission in an acute
geriatric unit (AGU), demographic and pharmacological data were collected to determine related associated factors. The
main outcome was prevalence and type of PIMs (by STOPP-Frail criteria). Measured clinical outcomes were adverse drug
events, length of stay, location upon discharge, in-hospital mortality and 1-year survival.
Results Two hundred thirty-ﬁve patients (mean age 86.80; 65.50% women) were recruited. Overall, 67.2% of patients had
≥ 1 criterion (mainly ‘drugs without clinical indication’ due to alimentary tract and metabolism drugs). Related factors
associated with PIMs according to STOPP-Frail criteria were moderate polypharmacy (OR 7.16 CI 95% 2.27–22.52) and
excessive polypharmacy (OR 7.30 CI 95% 2.34–22.73), but not advanced age (OR 0.26 CI 95% 0.12–0.53) or previous
hospitalisations (OR 0.61 CI 95% 0.48–0.79). There were no diﬀerences in clinical outcomes.
Conclusion PIMs according to STOPP-Frail are often used in palliative care patients. PIMs were associated with polyphar-
macy, but no related morbidity or mortality eﬀects have been observed.
Keywords Chronic disease · Palliative care · Potentially inappropriate medications · STOPP-Frail criteria
Potentially inappropriate medications (PIMs) are common
in adult patients and are associated with negative clinical
outcomes [1, 2]. This is also true for patients with advanced
chronic conditions and who are in need of palliative care
Electronic supplementary material The online version of this
article (https ://doi.org/10.1007/s4199 9-018-0073-z) contains
supplementary material, which is available to authorized users.
* Daniel Sevilla-Sánchez
Pharmacy Department, Hospital Universitari de Vic –
Consorci Hospitalari de Vic, C/Francesc Pla El Vigatà núm
1, 08500 Vic, Barcelona, Spain
Hospital de la Santa Creu de Vic, Vic, Barcelona, Spain
Acut Geriatric Unit, Hospital de la Santa Creu de Vic, Vic,
Geriatric and Palliative Care Territorial Unit, Hospital de
la Santa Creu de Vic, Consorci Hospitalari de Vic, Vic,
Palliative Care Chair – Vic University – Central University
of Catalonia, Vic, Barcelona, Spain
Pharmacy Department, Hospical Clinic de Barcelona,
Central Catalonia Chronicity Research Group (C3RG), Vic,