Application of STOPP/START and Beers criteria: Compared analysis on identification and relevance of potentially inappropriate prescriptions

Boland, Benoît; Guignard, Bertrand; Dalleur, Olivia; Lang, Pierre-Olivier

doi:10.1016/j.eurger.2016.03.010

Cited by 25 publications

(23 citation statements)

References 43 publications

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“…We found increased prevalence rates of inappropriate prescribing events with the updated criteria, which was consistent with previous studies 11,16 . The percentage of patients with PIMs/PPOs in our analysis was close to a study conducted in Italy in geriatric patients ≥65 years who were admitted in the internal medicine units, 17 higher than a study conducted in Spain in community‐dwelling residents ≥65 years, 5 and lower than a study conducted in patients ≥75 years who were admitted to non‐geriatric units in Belgium 11 .…”

Section: Discussionsupporting

confidence: 89%

Potentially inappropriate medications and potentially prescribing omissions in Chinese older patients: Comparison of two versions of STOPP/START

Tong

Zhang

2020

J Clin Pharm Ther

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What is known and objective The aim of this study was to compare the prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) in elderly Chinese patients identified by the Screening Tool of Older Persons’ Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) version 2 (v2) and version 1 (v1). The secondary objective was to analyse the risk factors associated with the PIMs/PPOs. Methods This was a retrospective cross‐sectional study, and all patients were aged ≥65 years and discharged from internal medical wards of Beijing Chaoyang Hospital in December 2018. STOPP/START v2 and STOPP/START v1 were used to detect PIMs/PPOs. The concordance between the two versions was calculated using kappa tests. A logistic regression analysis was carried out to determine variables independently associated with PIM/PPO use. Results and discussion In the 662 patients included, the median age was 73 years and 361 were male (54.53%). PIMs were present in 36.1% and 47.7% of participants according to the STOPP v1 and STOPP v2, respectively. The prevalence of PPOs was 42.0% and 64.2% according to the START v1 and START v2, respectively. Drug prescribed without indication was the most common item in PIMs, whereas ACEIs were the drugs most frequently involved with PPOs according to the STOPP/START v2. Two versions of the STOPP criteria indicated a moderate coherence, whereas two versions of the START criteria showed poor accordance. Age (OR 1.029, 1.004‐1.054), gender (OR 1.536, 1.103‐2.138) and the number of prescribed medications (<5: OR 1; 5‐9: OR 2.503, 1.173‐5.342; ≥10: OR 4.324, 2.204‐9.235) were associated factors with PIMs identified by the STOPP v2, whereas PPOs identified by the START v2 were independently associated with age (OR 1.039, 1.012‐1.066), activities of daily living (ADL) score (OR 2.713, 1.818‐4.048), the number of prescribed medications (<5: OR 1; 5‐9: OR 2.704, 1.524‐4.795; ≥10: OR 3.075, 1.704‐5.549) and Charlson Comorbidity Index (OR 1.302, 1.110‐1.529). What is new and conclusion This study showed a high prevalence of PIMs/PPOs in aged internal medical ward inpatients in China, which was associated with various correlates. The STOPP/START v2 had a higher detection rate than v1.

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Section: Discussionsupporting

confidence: 89%

Potentially inappropriate medications and potentially prescribing omissions in Chinese older patients: Comparison of two versions of STOPP/START

Tong

Zhang

2020

J Clin Pharm Ther

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“…Versus other tools, some studies have shown that the STOPP-START tool can identify a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events, 16 can reduce the highest number of medications and can identify more potential major clinical issues. 18 The criteria for STOPP-START have been associated with improvement in prescribing quality and clinical outcomes. 19 These criteria have been adapted for other languages, such as French.…”

Section: Introductionmentioning

confidence: 99%

Translation and adaptation of the STOPP-START screening tool to Portuguese for detecting inappropriate prescriptions in older people: a protocol

et al. 2021

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IntroductionRational prescribing for older adults is a challenge because they usually exhibit multimorbidity and multimedication. One available and reliable tool to tackle this issue consists of the Screening Tool of Older People’s Prescriptions (STOPP) and the Screening Tool to Alert to Right Treatment (START), which has been associated with improvements in clinical outcomes. Our goal here is to translate and validate the STOPP-START screening tool for use with Portuguese general practitioners/family physicians.Methods and analysisThe study will be conducted in four phases: phase I—translation of the STOPP-START screening tool to Portuguese; phase II—data collection of patient data; phase III—intrarater reliability and agreement study; and phase IV—inter-rater reliability and agreement study.Ethics and disseminationThis study was approved by the Ethics Committee of the Central Health Region of Portugal (where the study will take place). Every participant will sign a written consent form. We intend to publish the full article in a related peer-reviewed journal, conference presentations, reports and in a PhD thesis.

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“…Regarding appropriateness, several tools have been developed for assessing the appropriateness of medications for older adults including the Beers criteria 17 and STOPP/START tool (Screening Tool of Older Person’s Prescriptions/Screening Tool to Alert doctors to Right Treatment) 18 . The Beers criteria is a widely used consensus criteria for medication use in older adults which describes potentially inappropriate drugs for this population based on their high risk of adverse outcomes such as falls and mortality 17 , 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study

Carr

Federman

Dzahini

et al. 2021

Sci Rep

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Polypharmacy is commonly defined based on the number of medications taken concurrently using standard cut-offs, but several studies have highlighted the need for a multidimensional assessment. We developed a multidimensional measure of polypharmacy and compared with standard cut-offs. Data were extracted for 2141 respondents of the 2007 Prescription Drug Survey, a sub-study of the Health Retirement Study. Latent classes were identified based on multiple indicators of polypharmacy, including quantity, temporality and risk profile. A four-class model was selected based on fit statistics and clinical interpretability: ‘High risk, long-term’ (Class 1), ‘Low risk, long-term’ (Class 2), ‘High risk, short-term’ (Class 3), and ‘High risk for drug interactions, medium-term, regular’ (Class 4). Classes differed regarding sex, cohabitation, disability and multimorbidity. Participants in the ‘low risk’ class tended to be male, cohabitating, and reported fewer health conditions, compared to ‘high risk’ classes. Polypharmacy classes were compared to standard cut-offs (5+ or 9+ medications) in terms of overlap and mortality risk. The three ‘high risk’ classes overlapped with the groups concurrently taking 5+ and 9+ medications per month. However, the multidimensional measure further differentiated individuals in terms of risk profile and temporality of medication taking, thus offering a richer assessment of polypharmacy.

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Application of STOPP/START and Beers criteria: Compared analysis on identification and relevance of potentially inappropriate prescriptions

Cited by 25 publications

References 43 publications

Potentially inappropriate medications and potentially prescribing omissions in Chinese older patients: Comparison of two versions of STOPP/START

Potentially inappropriate medications and potentially prescribing omissions in Chinese older patients: Comparison of two versions of STOPP/START

Translation and adaptation of the STOPP-START screening tool to Portuguese for detecting inappropriate prescriptions in older people: a protocol

A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study

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