A comparison of the <scp>B</scp>eers and <scp>STOPP</scp> criteria for identifying the use of potentially inappropriate medications among elderly patients in primary care

Oliveira, Márcio Galvão; Amorim, Welma Wildes; Jesus, Sandra Rego de; J, Heine; Coqueiro, Hérica Lima; Passos, Luiz Carlos Santana

doi:10.1111/jep.12319

Cited by 54 publications

(67 citation statements)

References 20 publications

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“…26 Aliás, as diferenças na prática clínica, no nível socioeconômico e nas regulamentações do sistema de saúde, influenciam na conduta das prescrições e reforçam a necessidade de adequação dos critérios à realidade do país. 27 A escolha dos Critérios de Beers e do STOPP como base para a elaboração do consenso nacional foi devida à sua ampla utilização e complementaridade. Alguns estudos mostraram diferenças nas prevalências de MPI, detectadas pelos Critérios de Beers e pelo STOPP, indicando que os dois critérios diagnósticos deveriam ser aplicados concomitantemente e de forma complementar para identificar RAM e minimizar a prescrição de MPI.…”

Section: -42unclassified

“…Embora os critérios de Beers e o STOPP apresentem semelhanças e algumas recomendações em comum, na tomada de decisão quanto à prescrição de medicamentos para idosos indica-se seu uso complementar e combinado. 27 Por outro lado, devido às diferenças na disponibilidade dos fármacos, assim como em relação às diferentes condutas prescritivas adotadas, esses instrumentos têm sido adaptados em muitos países. 11 …”

Section: Introductionunclassified

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Consenso brasileiro de medicamentos potencialmente inapropriados para idosos

Oliveira¹,

Amorim²,

Oliveira³

et al. 2017

Geriatr., Gerontol. Aging

Self Cite

107

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RESUMOOBJETIVO: Realizar a validação de conteúdo dos Critérios de Beers 2012 e STOPP 2006 para a obtenção de critérios nacionais de classificação de medicamentos potencialmente inapropriados (MPI) para idosos. MÉTODOS: A técnica Delphi modificada em duas etapas foi utilizada para o estabelecimento do Consenso Brasileiro de Medicamentos Potencialmente Inapropriados para Idosos, com base nos critérios de Beers 2012 e STOPP 2006. O painel de especialistas foi composto por dez indivíduos. Utilizou-se um questionário eletrônico em que cada especialista emitiu uma nota, por meio de uma escala de Likert de cinco pontos. Na primeira etapa Delphi, os participantes foram solicitados a avaliar a inadequação potencial de uma lista preliminar de medicamentos e propor sugestões. Posteriormente, calculou-se a média das notas e o respectivo IC de 95% para cada critério. Foram encaminhados para a segunda rodada os critérios com limite máximo de IC95% < 4,0. Todos os medicamentos contidos em critérios com um limite mínimo de IC95% ≥ 4,0 na segunda rodada foram classificados como potencialmente inapropriados. RESULTADOS: Os critérios que não obtiveram consenso foram: uso de aspirina para a prevenção primária de eventos cardiovasculares, prescrição de escala móvel de insulina, uso de alfa-bloqueadores, estrógenos orais ou transdérmicos para idosos com incontinência urinária e antidepressivos tricíclicos para aqueles com retenção urinária. Ao final, foram totalizados 118 critérios, sendo 43 independentes de condição clínica e 75 dependentes de condição clínica/doença dos idosos. CONCLUSÃO: Foi realizada a validação de conteúdo de critérios de medicamentos que devem ser evitados em idosos. Esses dados podem otimizar a prescrição de medicamentos nessa população. PALAVRAS-CHAVE: lista de medicamentos potencialmente inapropriados; idoso; Brasil. An electronic questionnaire was used, in which each expert scored the criteria through a 5-points Likert scale. In the first round, the participants were asked to assess the potential inadequacy of a preliminary list of medicines and propose suggestions. Then, for each criterion, the scores mean was calculated and its respective 95% CI. The criteria with a 95% CI < 4,0 upper limit were submitted to the second round. All medicines in the criteria with a 95% CI ≥ 4,0 lower limit, in the second round, were classified as potentially inappropriate. RESULTS: The criteria that did not reach consensus were: aspirin use for primary prevention of cardiovascular events, sliding scale insulin prescription and the use of alpha-blockers, oral or transdermal estrogens and tricyclic antidepressants for the elderly with urinary tract incontinence. At the end, there were 118 criteria, in which 43 were independent from clinical conditions and 75 were dependent from clinical conditions/disease of the elderly. CONCLUSION: It was validated a criteria of medicines that should be avoided in the elderly. These data can optimize the medicines prescription in this population.

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Section: -42unclassified

Section: Introductionunclassified

Consenso brasileiro de medicamentos potencialmente inapropriados para idosos

Oliveira¹,

Amorim²,

Oliveira³

et al. 2017

Geriatr., Gerontol. Aging

Self Cite

107

View full text Add to dashboard Cite

show abstract

“…Other drugs were excluded from the former criteria due to lack of scientific evidence or withdrawn from the market (Fick et al, 2015;O'Mahony et al, 2015). It is possible that the use of the revised criteria may reveal higher prevalence of PIMs, as it has been reported in recent Brazilian studies according to 2012 Beers (35.0-51.8%) (Ganassin, Matos, Toffoli-Kadri, 2014;Martins et al, 2015;Oliveira et al, 2015).…”

Section: Discussionmentioning

confidence: 98%

Exposure to potentially inappropriate medications in Brazilian elderly outpatients with metabolic diseases

Martins

Mori

Dórea

et al. 2016

Braz. J. Pharm. Sci.

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“…In deciding the appropriateness of medications during medications reviews, NPs can access effective screening criteria online, such as the Beers Criteria (Ilic et al, 2015;Oliveira et al, 2015). The MedStopper Application can also be accessed online to identify medications for potential discontinuation (MedStopper Beta, 2015), as well as OPRC guidelines that go further to guide the deprescribing process (OPRC, 2015).…”

Section: Medication Reviews and Screening Criteriamentioning

confidence: 99%

“…The Beers Criteria is evidence-informed, has recently demonstrated superiority in identifying potentially inappropriate medications (Oliveira et al, 2015), and it is the most utilized criteria over the past 20 years (Lemay & Dalziel, 2012). This demonstrates its ongoing clinical usefulness.…”

Section: Problematic Polypharmacy Reduction Strategiesmentioning

confidence: 99%

The role of the nurse practitioner in promoting a reduction in the causes and outcomes of problematic polypharmacy among nursing home residents in British Columbia

Jassar¹

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Problematic polypharmacy is an ongoing issue for older adults throughout Canada, and specifically among nursing home residents (Maher, Hanion, & Hajjar, 2013). Despite interventions that are currently in place in British Columbia (BC) to reduce the causes and outcomes of this issue, problematic polypharmacy continues to pose a risk for residents among BC nursing homes. This integrative review asks how nurse practitioners (NPs) can best promote a reduction in the causes and outcomes of problematic polypharmacy among residents in BC nursing homes.The background information of this project outlines the concept of problematic polypharmacy and the prevalence of contributing factors and outcomes. Nursing home demographics are also highlighted to demonstrate the risk this population faces to the causes and outcomes of problematic polypharmacy, and the subsequent effect this issue has on the health care system. Furthermore, the background provides an overview of the concept role overlap which exists between health care professionals in order to demonstrate how multiple health care professionals may share roles or parts of roles in reducing the causes and outcomes of problematic polypharmacy. Barriers faced by staff are also examined.Through a comprehensive review of the literature and critical appraisal, nine articles are found to address the research question. Key interventions that specifically demonstrate effectiveness in reducing causes and outcomes of problematic polypharmacy in the context of nursing homes emerged. These interventions are put forth as recommendations for NP practice and include: medication reviews while screening for inappropriate medications by using the Beers Criteria, computerized clinical decision support systems (CCDSS), and the Cockcroft Gault Score; assessing functional status for changes to assure instances of problematic 3 polypharmacy are not missed by using the Minimum Data Set -Activity of Daily Living (MDS-ADL) scale; education targeted for all staff members to detect, prevent, and manage problematic polypharmacy; multidisciplinary team meetings to facilitate a collaborative approach in reducing problematic polypharmacy and case conferences to provide resident-centered care.An important finding is that most interventions require participation from two or more health professionals, highlighting the concept of role overlap and the necessity of a multidisciplinary approach. In light of NP practice, this provides insight surrounding how NPs can influence and encourage other staff members to sustain their roles and overcome barriers for an ultimate reduction in the causes and outcomes of problematic polypharmacy with implications for practice, policy, education, and research.

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A comparison of the Beers and STOPP criteria for identifying the use of potentially inappropriate medications among elderly patients in primary care

Abstract: The 2012 Beers criteria identified more PIMs than the STOPP criteria. This difference highlights the need to develop national criteria.

Cited by 54 publications

References 20 publications

Consenso brasileiro de medicamentos potencialmente inapropriados para idosos

Consenso brasileiro de medicamentos potencialmente inapropriados para idosos

Exposure to potentially inappropriate medications in Brazilian elderly outpatients with metabolic diseases

The role of the nurse practitioner in promoting a reduction in the causes and outcomes of problematic polypharmacy among nursing home residents in British Columbia

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