title: Prescribing omissions in elderly patients admitted to a stroke unit: descriptive study using START criteria.
abstract: BACKGROUND
  Underuse of medication considered beneficial is particularly common in elderly patients. A new Screening Tool to Alert Doctors to the Right Treatment (START) has been published to identify potential prescribing omissions.
  
  
  OBJECTIVE
  To quantify and characterize potential prescribing omissions of cardiovascular risk management therapy using START criteria.
  
  
  METHODS
  This study was conducted in the Stroke Unit of the university teaching hospital of Cova da Beira Hospital Centre, Covilhã, located in the Eastern Central Region of Portugal.
  
  
  METHODS
  During 6 months, the medical files of all elderly patients (age ≥ 65 years) admitted with acute cardiovascular disease were reviewed and the START criteria applied to the information of medication, at admission and at the time of discharge from the hospital Stroke Unit.
  
  
  METHODS
  Potential prescribing omissions of cardiovascular and endocrine pharmacological therapy were identified and the difference in the potential prescribing omissions between admission and discharge from hospital Stroke Unit was also evaluated.
  
  
  RESULTS
  At the time of admission to the Stroke Unit, 101 potential prescribing omissions were found in 68.1 % (n = 91) of elderly (average 1.11 omissions per patient), of which 84.2 % (n = 85) were corrected at the time of discharge. In 14 patients, 16 omissions found at admission were not corrected during hospitalization, and in 5 patients 5 new omissions were detected.
  
  
  CONCLUSIONS
  Prescribing omissions of beneficial drugs are highly prevalent in acutely ill admitted to a Stroke Unit. START criteria represent a simple, evidence-based and easy-to-use tool to screen underuse of cardiovascular risk management therapy in elderly patients.
authors.affiliation: Faculty of Health Sciences, University of Beira Interior, Av. Infante D. Henrique, 6200-506, Covilhã, Portugal. elisabete.borges@gmail.com
authors.forename: Elisabete Pinto
authors.initials: EP
authors.lastname: Borges
authors.forename: Manuel
authors.initials: M
authors.lastname: Morgado
authors.forename: Ana Filipa
authors.initials: AF
authors.lastname: Macedo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000592:standards; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D010343:Patient Admission / Q000592:standards*; D010820:Physicians / Q000592:standards*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology