Actualización de los criterios STOPP-START: una herramienta para la detección de medicación potencialmente inadecuada en ancianos

Acosta, Cristian Gallo; Vilosio, Javier Oscar; Saimovici, Javier

doi:10.51987/evidencia.v18i4.6366

Cited by 9 publications

(14 citation statements)

References 2 publications

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“…The STOPP/START criteria were developed two decades ago to detect PIPs and improve therapeutic appropriateness in older patients. However, recent studies concluded that the prevalence of PIPs remains high, especially in NH residents [11,35,64].…”

Section: Discussionmentioning

confidence: 99%

“…PIPs also include: (i) the use of medicines at a higher dose than indicated; (ii) the use of medicines with a high risk of drug-drug or drug-disease interactions; (iii) duplications. Not using clinically indicated beneficial medicines are also considered to be PIPs [11].…”

Section: Introductionmentioning

confidence: 99%

“…The most widely used explicit methods in recent decades in institutionalized patients to detect PIPs and optimize medicine use have been the Beers' criteria [20] and Screening Tool of Older Persons potentially inappropriate Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) [11,13]. The STOPP/START criteria were first described by Gallagher et al in 2008 [21], and although not originally intended for use in NH residents, have been shown to be more sensitive than the Beers' criteria for the detection of PIPs in this patient group [13,22,23].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

et al. 2023

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The demand for long-term care is expected to increase due to the rising life expectancy and the increased prevalence of long-term illnesses. Nursing home residents are at an increased risk of suffering adverse drug events due to inadequate prescriptions. The main objective of this systematic review is to collect and analyze the prevalence of potentially inadequate prescriptions based on the new version of STOPP/START criteria in this specific population. Databases (PubMed, Web of Science and Cochrane) were searched for inappropriate prescription use in nursing homes according to the second version of STOPP/START criteria. The risk of bias was assessed with the STROBE checklist. A total of 35 articles were assessed for eligibility. One hundred and forty nursing homes and more than 6900 residents were evaluated through the analysis of 13 studies of the last eight years. The reviewed literature returned prevalence ranges between 67.8% and 87.7% according to the STOPP criteria, according to START criteria prevalence ranged from 39.5% to 99.7%. The main factors associated with the presence of inappropriate prescriptions were age, comorbidities, and polypharmacy. These data highlight that, although the STOPP/START criteria were initially developed for community-dwelling older adults, its use in nursing homes may be a starting point to help detect more efficiently inappropriate prescriptions in institutionalized patients. We hope that this review will help to draw attention to the need for medication monitoring systems in this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

et al. 2023

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“…This knowledge base focuses on describing the most common errors in drug prescription. One of their most important features is that these criteria can be integrated into computer systems [ 28 ]. This knowledge base is used at the European level to analyze drugs prescribed to older adult patients.…”

Section: Methodsmentioning

confidence: 99%

A Personalized Ontology-Based Decision Support System for Complex Chronic Patients: Retrospective Observational Study

Román-Villarán¹,

Alvarez-Romero²,

Martínez-García³

et al. 2022

JMIR Form Res

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Background Due to an increase in life expectancy, the prevalence of chronic diseases is also on the rise. Clinical practice guidelines (CPGs) provide recommendations for suitable interventions regarding different chronic diseases, but a deficiency in the implementation of these CPGs has been identified. The PITeS-TiiSS (Telemedicine and eHealth Innovation Platform: Information Communications Technology for Research and Information Challenges in Health Services) tool, a personalized ontology-based clinical decision support system (CDSS), aims to reduce variability, prevent errors, and consider interactions between different CPG recommendations, among other benefits. Objective The aim of this study is to design, develop, and validate an ontology-based CDSS that provides personalized recommendations related to drug prescription. The target population is older adult patients with chronic diseases and polypharmacy, and the goal is to reduce complications related to these types of conditions while offering integrated care. Methods A study scenario about atrial fibrillation and treatment with anticoagulants was selected to validate the tool. After this, a series of knowledge sources were identified, including CPGs, PROFUND index, LESS/CHRON criteria, and STOPP/START criteria, to extract the information. Modeling was carried out using an ontology, and mapping was done with Health Level 7 Fast Healthcare Interoperability Resources (HL7 FHIR) and Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT; International Health Terminology Standards Development Organisation). Once the CDSS was developed, validation was carried out by using a retrospective case study. Results This project was funded in January 2015 and approved by the Virgen del Rocio University Hospital ethics committee on November 24, 2015. Two different tasks were carried out to test the functioning of the tool. First, retrospective data from a real patient who met the inclusion criteria were used. Second, the analysis of an adoption model was performed through the study of the requirements and characteristics that a CDSS must meet in order to be well accepted and used by health professionals. The results are favorable and allow the proposed research to continue to the next phase. Conclusions An ontology-based CDSS was successfully designed, developed, and validated. However, in future work, validation in a real environment should be performed to ensure the tool is usable and reliable.

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“…Existen medicamentos potencialmente inapropiados (MPI) para los adultos mayores por su riesgo significativo de causar una RAM en este grupo etario. Se los considera de esa manera por existir alternativas terapéuticas más seguras, por utilizarse a dosis inapropiadas o por tiempos excesivos, o por interactuar negativamente con otros fármacos o patologías del usuario (3) .…”

Section: Introductionunclassified

Uso ambulatorio de medicamentos potencialmente inapropiados en adultos mayores usuarios de la RAP Metropolitana de ASSE durante 2019

2023

RMU

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Introducción: los adultos mayores son una población de riesgo para el desarrollo de reacciones adversas a los medicamentos. Los medicamentos potencialmente inapropiados son aquellos que representan mayores riesgos que beneficios en este grupo etario. Se cuenta con herramientas de apoyo a la prescripción en geriatría que permiten identificar a estos medicamentos y mediante la aplicación de estudios de utilización de medicamentos, podemos describir o analizar el uso de los mismos en una población.Objetivos: reconocer disponibilidad de medicamentos potencialmente inapropiados para adultos mayores en la RAP metropolitana de ASSE durante 2019 y establecer un diagnóstico de situación de consumo de los mismos durante ese año.Método: se realizó un análisis del vademécum institucional mediante la aplicación de los Criterios de Beers 2019 y dos escalas de riesgo anticolinérgico para identificar medicamentos potencialmente inapropiados. Posteriormente se realizó un estudio de utilización de los medicamentos identificados, mediante datos de dispensación de farmacia entre el 1 de enero y 31 de diciembre de 2019. El consumo se expresó en Dosis Diarias Definidas por cada 1000 adultos mayores-año (DHD).Resultados: se identificaron 16 medicamentos potencialmente inapropiados, de los cuales los más usados fueron clonazepam (DHD 69), quetiapina (65,6), alprazolam (DHD 43,7), flunitrazepam (DHD 42,7) y zolpidem (DHD 36,4).Conclusiones: la aplicación de herramientas explícitas facilita la identificación de medicamentos potencialmente inapropiados para adultos mayores y se evidenció un consumo elevado de los mismos durante el año 2019 a expensas de derivados benzodiazepínicos y quetiapina.

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Actualización de los criterios STOPP-START: una herramienta para la detección de medicación potencialmente inadecuada en ancianos

Cited by 9 publications

References 2 publications

Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review

A Personalized Ontology-Based Decision Support System for Complex Chronic Patients: Retrospective Observational Study

Uso ambulatorio de medicamentos potencialmente inapropiados en adultos mayores usuarios de la RAP Metropolitana de ASSE durante 2019

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