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

Abstract

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.

Attitudes of Older Adult Patients and Caregivers Towards Deprescribing of Medications in Ethiopia

“…35 They are at greater risk of multimorbidity and thus complicated prescriptions that led to polypharmacy and potentially inappropriate medications. 36 According to Planelles and his co-authors most recent meta-analysis 37 on older adult patients, PIM prevalence was extremely high (87.7%).The occurrence of PIM is mostly attributed to aging, comorbidities, and polypharmacy, according to numerous research. 37,38 PIM is also linked to a higher risk of falling, hospitalization, mortality, a general decline in quality of life, and other negative drug events in older adult people.…”

“…36 According to Planelles and his co-authors most recent meta-analysis 37 on older adult patients, PIM prevalence was extremely high (87.7%).The occurrence of PIM is mostly attributed to aging, comorbidities, and polypharmacy, according to numerous research. 37,38 PIM is also linked to a higher risk of falling, hospitalization, mortality, a general decline in quality of life, and other negative drug events in older adult people. [39][40][41] Deprescribing is a crucial and efficient strategy for minimizing PIM usage and preventing harmful medication events or outcomes in older adult patients.…”

The effects of triage applying artificial intelligence on triage in the emergency department: A systematic review of prospective studies

“…The COR (%) was calculated using the formula (yes / [yes + no]) × 100. Planelles et al [44] categorized COR scores as "low" for scores between 0% and 49%, "moderate" for scores between 50% and 74%, and "high" for scores of 75% or higher. In addition, the STROBE results for all the selected articles were summarized to assess the extent of reporting for each speci c item in terms of frequency and percentage.…”

Revisiting systematic reviews on deprescribing trials to better inform future practice and research

“…It is estimated that one-to two-thirds of older people are prescribed a medicine with more harm than benefit. 6,7 Deprescribing may improve overall adherence to essential drugs while reducing costs, inconvenience and medication-related harms. 5 There has been an increasing amount of research around deprescribing in older adults over the last 15 years.…”

“…Deprescribing is highly relevant in the context of older adults with multimorbidy, polypharmacy and low adherence to medications. It is estimated that one‐ to two‐thirds of older people are prescribed a medicine with more harm than benefit 6,7 . Deprescribing may improve overall adherence to essential drugs while reducing costs, inconvenience and medication‐related harms 5 …”