Potentially inappropriate prescribing (PIP) in long-term care (LTC) patients: validation of the 2014 STOPP-START and 2012 Beers criteria in a LTC population—a protocol for a cross-sectional comparison of clinical and health administrative data

Abstract

IntroductionPotentially inappropriate prescribing (PIP) is frequent and problematic in older patients. Identifying PIP is necessary to improve prescribing quality; ideally, this should be performed at the population level. Screening Tool of Older Persons’ potentially inappropriate Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) and Beers criteria were developed to identify PIP in clinical settings and are useful at the individual patient level; however, they are time-consuming and costly to apply. Only a subset of these criteria is applicable to routinely collected population-level health administrative data (HAD) because the clinical information necessary to implement these tools is often missing from databases. The performance of subsets of STOPP/START and Beers criteria in HAD compared with clinical data from the same patients is unknown; furthermore, the performance of the updated 2014 STOPP-START and 2012 Beers criteria compared with one another is also unknown.Methods and analysisA cross-sectional study of linked HAD and clinical data will be conducted to validate the subsets of STOPP/START and Beers criteria applicable to HAD by comparing their performance when applied to clinical and HAD for the same patients. Eligible patients will be 66 years and over and recently admitted to 1 of 6 long-term care facilities in Ottawa, Ontario. The target sample size is 275, but may be less if statistical significance can be achieved sooner. Medication, diagnostic and clinical data will be collected by a consultant pharmacist. The main outcome measure is the proportion of PIP missed by the subset of STOPP/START and Beers criteria applied to HAD when compared with clinical data.Ethics and disseminationThe study was approved by the Ottawa Health Services Network Research Ethics Board, the Bruyère Continuing Care Research Ethics Board and the ethics board of the City of Ottawa Long Term Care Homes. Dissemination will occur via publication, national and international conference presentations, and exchanges with regional, provincial and national stakeholders.Trial registration numberNCT02523482.

Polytherapy and the risk of potentially inappropriate prescriptions (PIPs) among elderly and very elderly patients in three different settings (hospital, community, long-term care facilities) of the Friuli Venezia Giulia region, Italy: are the very elderl

“…The predictive validity of the STOPP criteria was recently shown slightly outperforming the Beers criteria to detect adverse drug events, but definitive evidence is still lacking . Hopefully, prospective randomized studies that are currently ongoing could clarify the matter definitely . Finally, we recognize the lack of collecting any parameter measuring social and clinical impacts.…”

Stakeholder Feedback of Electronic Medication Adherence Products: Qualitative Analysis

“…Residents in LTC facilities use more drugs than those in the community because they tend to be older, more frail and sicker than seniors living in the community. 6,53,54 This increased drug use continues even after adjusting for clinical characteristics. 55 An Ontario study found that, on average, younger LTC residents used more drugs than older LTC residents and that there was high variation in the number of drugs used by LTC residents across facilities.…”

Potentially inappropriate medication in long-term care wards of a veteran hospital in Taiwan: Investigation using a spreadsheet-based rapid assessment tool

“…Evaluating PIM use can reduce ADEs and the incidence of hospitalization among older adults. 27 The current approach used to manually assess PIM use is timeconsuming and difficult to be generalized. The rapid assessment tool designed in this study may enable pharmacists to rapidly screen PIMs during the implementation of medication integration.…”