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Potentially inappropriate medication in palliative care patients according to STOPP-Frail criteria

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Potentially inappropriate medications (PIMs) are common in palliative care patients, but no specific tools have been used to determine these PIMs.


To evaluate the prevalence of PIMs according to specific tool ‘STOPP-Frail’, related factors with its existence and clinical consequences.


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.


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.


PIMs according to STOPP-Frail are often used in palliative care patients. PIMs were associated with polypharmacy, but no related morbidity or mortality effects have been observed.

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We thank all the nurses, patients and caregivers who have participated and collaborated in the study.


This study was partially supported by a Ph.D. Research Fellowship Granted by “Consultori Bayes”. The funders had no role in the design, execution, analysis, interpretation or writing of the study.

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All authors were responsible for critical revisions of the manuscript and for important intellectual content. All authors approved the final contents of the manuscript.

Corresponding author

Correspondence to Daniel Sevilla-Sánchez.

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The authors declare that they have no conflict of interest with respect to the research, authorship and/or publication of this article.

Ethics approval

This study was approved by the local Ethics Committee (ID Number: PR82-2014852). All procedures performed in this study met the ethical standards of the committee and the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was obtained from all of the participants (or caregivers) included in the study.

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Sevilla-Sánchez, D., Molist-Brunet, N., Espaulella-Panicot, J. et al. Potentially inappropriate medication in palliative care patients according to STOPP-Frail criteria. Eur Geriatr Med 9, 543–550 (2018).

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