Inappropriate Prescribing and Related Hospital Admissions in Frail Older Persons According to the STOPP and START Criteria

Dalleur, Olivia; Spinewine, Anne; Henrard, Séverine; Losseau, Claire; Speybroeck, Niko; Boland, Benoît

doi:10.1007/s40266-012-0016-1

Cited by 146 publications

(135 citation statements)

References 39 publications

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“…15,16 It was as high as 51% in a study conducted by Delleur. 17 A study conducted by Gallenger reports the proportion on PIMs to be between 12-40% and the results of the present study falls between the same range. 18 Thus, studies conducted all over the world on geriatric patients have shown wide variations with respect to this parameter.…”

Section: Discussionsupporting

confidence: 79%

“…Study published in European Journal of pharmacology shows prescription of NSAIDs in patients of hypertension as a common PIM while studies analyzing prescriptions as per Beers criteria show common PIMs related to prescription of antihistaminic, muscle relaxants and long acting benzodiazepines . [16][17][18][19] Thus, criteria adopted for identification of PIMs play a very important role in explaining the discrepancies between studies in this regard. Other explanations for differences in the type of PIPs reported from studies conducted in different geographical areas may be related to the epidemiology of diseases treated in a particular area, local availability of drugs, cost and treatments guidelines followed in a particular setup.…”

Section: Discussionmentioning

confidence: 99%

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Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario

Murthy¹,

Jagtap²,

Burute³

et al. 2017

Int J Basic Clin Pharmacol

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Background: Patients; sixty-five years of age and above, are a special risk group as far as drug prescribing is concerned. Prescription irregularities in such patients may be hazardous. STOPP/START criteria are considered as the most up to-date set of explicit criteria for evaluating geriatric prescriptions. To analyse geriatric prescriptions in a tertiary care centre with respect to STOPP/START criteria and WHO core drug prescribing indicators so as to get an idea of pattern of drug prescription in geriatric patients as well as frequency of potentially inappropriate prescriptions. Descriptive cross-sectional study in a tertiary care hospital.Methods: All inpatients aged 65 years and above who were prescribed at least one allopathic medication and consented to participate in the study were included and patients admitted for medical emergencies were excluded. Demographic data and details of drugs prescribed were collected from prescription chits and indoor case papers.Results: There was a high frequency of polypharmacy, prescription of antimicrobials and injections. Proportion of patients receiving at least one potentially inappropriate medication (PIM) as per STOPP criteria was 21.01%. Proportion of patients subjected to at least one potential prescribing omission (PPO) as per START criteria was 33.33%. Proportion of patients exposed to potentially inappropriate drug prescriptions as a whole (PIPs=PIMs+PPOs) was 46.37%. Statistical analysis used as descriptive statistics like numbers and percentages were used for data analysis.Conclusions: With regards to geriatric prescribing, adherence to WHO core prescribing indicators, prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario

Murthy¹,

Jagtap²,

Burute³

et al. 2017

Int J Basic Clin Pharmacol

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“…Most of them were discharged and went home. In our study, polypharmacy was higher than that described in other studies focusing on patients' medicine consumption on hospital admission [11,13,28]. However, an exhaustive pharmacology anamnesis study was carried out in our study analysing the consumption of drugs the month before admission, not only at the time of admission, as well as a complete review of drug utilization from the primary care and hospital electronic medical records, and performing an exhaustive drug interview of patients and/or relatives.…”

Section: Discussionmentioning

confidence: 75%

Inappropriate prescribing to older patients admitted to hospital: A comparison of different tools of misprescribing and underprescribing

San-José

Agustí

Vidal

et al. 2014

European Journal of Internal Medicine

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Methods: An observational, prospective and multicentric study was carried out in the internal medicine services of seven Spanish hospitals. Patients aged 75 years and older were randomly selected after hospital admission for a year. To assess potentially inappropriate medicines (PIMs), the Beers and STOPP criteria were used and to assess Potentially Prescribing Omissions (PPOs), the START criteria and ACOVE-3 medicine quality indicators were used. An analysis to assess factors associated with IP was performed.Results: 672 patients [median age (Q1_Q3) 82 (79-86) years, 55.9% female] were included. Median prescribed medicines in the month prior to hospitalization were 10(Q1-Q3 7-13). The prevalence of IP was 87.6%, and 54.3% of patients had PIMs and PPOs concurrently. A higher prevalence rate of PIMs was predicted using the STOPP criteria than with the Beers criteria (p<.001) and a higher prevalence of PPOs using the ACOVE-3 criteria than using the START criteria (p<.001) was observed. Polypharmacy (≥10 medicines) was the strongest Conclusions: A high prevalence of polypharmacy and PIMs and PPOs were reported. More than half the patients had simultaneous PIMs and PPOs. The related factors to PIMs and PPOs were different.

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“…Existe abundante bibliografía sobre estudios de detección de PPI en pacientes hospitalarios [5][6][7], en residencias sociosanitarias y, en menor medida, en atención primaria. Más allá de algunos estudios descriptivos [8,9] hay poca bibliografía publicada en farmacia comunitaria.…”

Section: Introductionunclassified

Prescripciones potencialmente inadecuadas en pacientes ancianos polimedicados. Intervención y seguimiento del farmacéutico comunitario

Bellver-Monzó¹,

Royo²,

Ibáñez³

2018

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RESUMENIntroducción: Las prescripciones potencialmente inadecuadas son causas de aparición de problemas relacionados con los medicamentos y de resultados negativos de la medicación, principalmente en ancianos. Los estudios en farmacia comunitaria son escasos.Objetivos: Mejorar la farmacoterapia de pacientes mayores de 65 años polimedicados mediante entrevista con el paciente. Realizar un perfil farmacoterapéutico, de hábitos en salud y adherencia. Medir la intervención del farmacéutico, derivación y satisfacción del paciente. Hacer una evaluación económica.Metodología: Se diseñó un estudio piloto descriptivo en pacientes de una farmacia comunitaria en Valencia. Se recogieron datos en una base Microsoft Acces®. Se midió la prevalencia de las prescripciones potencialmente inadecuadas mediante los criterios STOPP-START (2014) utilizando el software informático Checkthemeds®.Resultados: Se realizó sobre 88 pacientes, 77 (87,5%) finalizaron. La prevalencia de prescripciones potencialmente inadecuadas fue de un 33,0% (26,0% STOPP y 7,0% START), siendo la sección A de los criterios STOPP la mayoritaria (duplicidades terapéuticas y fármacos sin indicación basada en la evidencia). El estreñimiento fue la condición clínica más prevalente. También destacó la falta de adherencia (52,0%), así como un 77,0% de pacientes sin los requerimientos hídricos necesarios. Se intervino en un 36,0% de las prescripciones potencialmente inadecuadas encontradas con un grado de aceptación del 14,0%. Se estimó que en un 9,0% de las ocasiones se evitó derivación con un ahorro medio de 6,57 €/paciente.Conclusiones: La prevalencia de los criterios STOPP fue similar a otros estudios. La de los criterios START menor. La entrevista permite descartar falsas prescripciones potencialmente inadecuadas. La revisión sistemática y protocolizada mejora la farmacoterapia mediante la detección en intervención en las prescripciones potencialmente inadecuadas. Potentially inadequate prescriptions in polymedicated elderly patients. Community pharmacist's intervention and follow-up ABSTRACTBackground: Potentially inappropriate prescriptions are related with Medication Related Problems and Negative Medication Results, especially in the elderly. Few studies in community pharmacy are available.Objectives: To improve pharmacotherapy in patients over 65 years receiving more than five medicines. We investigated pharmacotherapy, healthy style, treatment adherence by conducting an open interview with the community pharmacist. Pharmacists´ interventions, patients´ satisfaction and costs were reported.Patients and methods: A descriptive study in a community pharmacy in Valencia (Spain) was designed. Data were collected in a Microsoft Acces® database and prevalence of potentially inappropriate prescriptions STOPP/START criteria 2014 was evaluated with the Checkthemeds® software. PALABRAS CLAVEAnciano, prescripción potencialmente inapropiada, criterios STOPP/START, farmacia comunitaria, revisión de la farmacoterapia, ahorro Financiación: ninguna. Conflicto de intereses: ni...

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Inappropriate Prescribing and Related Hospital Admissions in Frail Older Persons According to the STOPP and START Criteria

Cited by 146 publications

References 39 publications

Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario

Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario

Inappropriate prescribing to older patients admitted to hospital: A comparison of different tools of misprescribing and underprescribing

Prescripciones potencialmente inadecuadas en pacientes ancianos polimedicados. Intervención y seguimiento del farmacéutico comunitario

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