title: Adherence to guidelines and the screening tool of older persons' potentially inappropriate prescriptions criteria for colchicine dosing for gout treatment in beneficiaries of the Nova Scotia Seniors' Pharmacare Program.
abstract: OBJECTIVE
  Colchicine is commonly used in the management of gout; however, older persons have higher risks of toxicity. Accordingly, the Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) criteria for colchicine consider >3 months of treatment as potentially inappropriate in older persons. Recent evidence also suggests lower dosing of colchicine is as effective and results in fewer toxicities than high-dose colchicine. The objectives of this study were to determine the dose, duration, and prescribers of colchicine and to evaluate adherence to the STOPP criteria and international guidelines for colchicine in older persons.
  
  
  METHODS
  A retrospective, observational study was conducted from April 1, 2006 to March 31, 2011 to evaluate colchicine use. Nova Scotia Seniors' Pharmacare Program beneficiaries who met inclusion criteria for an incident case of gout and who filled at least 1 prescription for colchicine during the study period were included. Colchicine dose and duration were reported descriptively. Multivariate logistic regression was used to identify predictors of the study population in making a claim for colchicine >90 and >180 days.
  
  
  RESULTS
  A total of 518 persons were dispensed 1327 courses of colchicine during the study period. The mean daily dose of colchicine ranged from 1.39 to 1.50 mg. Colchicine doses >1.2 mg were prescribed in approximately one-third of the study population. Colchicine was prescribed for >90 days in 14.2% of treatment courses and for >180 days in 8.1% of treatment courses. Female sex was the only predictor of treatment duration >90 days.
  
  
  CONCLUSIONS
  This study is the first to report on colchicine dose and duration using STOPP criteria in a specific cohort of older persons with incident gout. Strategies to improve colchicine prescribing in older persons are needed.
authors.affiliation: College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Emily
authors.initials: E
authors.lastname: Black
authors.affiliation: College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: ingrid.sketris@dal.ca.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Sketris
authors.affiliation: College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Skedgel
authors.affiliation: College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: Erica
authors.initials: E
authors.lastname: MacLean
authors.affiliation: Division of Rheumatology, Nova Scotia Rehabilitation Centre, Capital Health, Halifax, Nova Scotia, Canada.
authors.forename: John G
authors.initials: JG
authors.lastname: Hanly
mesh_terms: D000368:Aged; D003078:Colchicine / Q000008:administration & dosage* / Q000009:adverse effects; D011307:Drug Prescriptions; D005260:Female; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D057970:Inappropriate Prescribing; D008297:Male; D009674:Nova Scotia; D012189:Retrospective Studies
chemical_list: D006074:Gout Suppressants; D003078:Colchicine
keywords: colchicine; dose; duration; gout; older persons