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 Clinical Therapeutics

Black, Emily, Sketris, Ingrid, Skedgel, Christopher, Mac Lean, Erica and Hanly, John G (2015) 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 Clinical Therapeutics. Clinical Therapeutics, 37 (10). 2339–2346. ISSN 0149-2918

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Abstract

Purpose: 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 43 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 1prescription 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 490 and 4180 days. Findings: 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 41.2 mg were prescribed in approximately one-third of the study population. Colchicine was prescribed for 490 days in 14.2% of treatment courses and for 4180 days in 8.1% of treatment courses. Female sex was the only predictor of treatment duration 490 days. Implications: 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.

Item Type: Article
Additional Information: (C) 2015 The Authors. Published by Elsevier HS Journals, Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Uncontrolled Keywords: colchicine,dose,duration,gout,older persons
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 13 Nov 2015 12:01
Last Modified: 14 Jul 2020 23:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/55186
DOI: 10.1016/j.clinthera.2015.08.016

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