title: The effect of pharmacists on ward rounds measured by the STOPP/START tool in a specialized geriatric unit.
abstract: OBJECTIVE
  The STOPP/START tool has been validated to assess elderly patients for potentially inappropriate prescribing. This study aimed to assess the effect of inclusion of a pharmacist on a physician-led ward round on potentially inappropriate prescribing in hospitalized elderly patients.
  
  
  METHODS
  This was an observational study of prescribing for patients using the STOPP/START tool at three points during hospital stay; admission to hospital, on transfer to the specialized geriatric unit and on discharge from hospital. Data were collected over 4 months pre- and post-introduction of a pharmacist to a physician-led ward round. Demographic and clinical data, including total number of medications and STOPP/START criteria met, were collected. The mean number of STOPP/START criteria at each time-point was compared for pre- and post-introduction of a pharmacist using a Mann-Whitney U-test. The mean number of criteria for each time-point within each group was compared using a paired Student's t-test.
  
  
  CONCLUSIONS
  The demographic characteristics of the participants in the pre- and post-intervention groups were similar. The post-intervention group had numerically less STOPP/START criteria, mean 1·18 (1·37) compared to the pre-intervention group 1·50 (1·41), P = 0·07 at discharge. The pre-intervention group had no significant change in the criteria from admission 1·78 (1·57) to geriatric unit transfer 1·72 (1·54) (P = 0·37); however, there was a significant decrease from geriatric unit transfer 1·72 (1·54) to discharge 1·50 (1·41) (P = 0·02). The post-intervention group had a significant decrease from hospital admission 2·30 (1·91) to geriatric unit transfer 1·59 (1·60) (P < 0·01) and again to discharge 1·18 (1·37) (P < 0·01).
  
  
  CONCLUSIONS
  Pharmacist participation on the ward round in a specialized geriatric unit resulted in a numerical improvement in prescribing quality as measured by the STOPP/START tool.
authors.affiliation: Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.|Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Mulvogue
authors.affiliation: Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.|Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, QLD, Australia.|Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: J A
authors.initials: JA
authors.lastname: Roberts
authors.affiliation: Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.|Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: I
authors.initials: I
authors.lastname: Coombes
authors.affiliation: Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Cottrell
authors.affiliation: Geriatric Evaluation and Management Unit, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Kanagarajah
authors.affiliation: Pharmacy Australia Centre of Excellence, The University of Queensland, Brisbane, QLD, Australia.|School of Pharmacy, University of Otago, Dunedin, New Zealand.
authors.forename: A
authors.initials: A
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D057970:Inappropriate Prescribing; D008297:Male; D008875:Middle Aged; D010595:Pharmacists
keywords: aging; clinical pharmacy; elderly; pharmacists; pharmacy practice; physician; prescribing practices