Reduction of Potentially Inappropriate Medications Using the STOPP Criteria in Frail Older Inpatients: A Randomised Controlled Study

Dalleur, Olivia; Boland, Benoît; Losseau, Claire; Henrard, Séverine; Wouters, Dominique; Speybroeck, Niko; Degryse, Jean-Marie; Spinewine, Anne

doi:10.1007/s40266-014-0157-5

Cited by 125 publications

(261 citation statements)

References 33 publications

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“…Deprescribing involves a completion of a review of an individual's current medications and subsequent withdrawal of inappropriate medications with supervision from a healthcare professional after careful consideration of the likelihood of adverse events with a goal of improving clinical outcomes [26,27]. Interventions for deprescribing have been trialled in residential aged care facilities, however the effects of these interventions as shown in randomised controlled trials (RCTs) have been mixed and further studies are required [28][29][30][31][32][33]26]. The high prevalence of DBIassociated medications and PIMs according to the Beers Criteria in the current study suggests that current recommendations for appropriate medication use in older adults may need to be better implemented in residential aged care settings.…”

Section: Discussionmentioning

confidence: 99%

Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care

et al. 2018

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Background: Inappropriate polypharmacy may negatively impact quality of life of residents in aged care facilities, but it remains unclear which medications may influence this reduced quality of life.Objective: The objective was to examine whether the Drug Burden Index (DBI) and potentially inappropriate medications (PIMs), were associated with quality of life in older adults living in residential care with a high prevalence of cognitive impairment and dementia.Methods: Cross-sectional analyses of 541individuals recruited from 17 residential aged care facilities in Australia in the Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study. Quality of life was measured using the EQ-5D-5L (a measure of generic quality of life) and the DEMQOL (a measure developed for use in dementia) completed by the participant or a proxy.Results: In the 100 days prior to recruitment, 83.1% of the participants received at least one anticholinergic or sedative medication included in the DBI and 82.7% received at least one PIM according to the Beers Criteria. Multi-level linear models showed there was a significant association between higher DBI and lower quality of life according to the EQ-5D-5L (β (SE): -0.034 (0.012), p=0.006) after adjustment for potential confounding factors. Increasing numbers of PIMs were also associated with lower EQ-5D-5L scores (-0.030 (0.010), p=0.003) and DEMQOL-Self-Report-Utility scores (-0.020 (0.009), p=0.029). Exposure to both DBI-associated medications and PIMs was associated with lower DEMQOL-SelfReport-Utility scores (-0.034 (0.017), p=0.049).Conclusion: Exposure to anticholinergic and sedative medications and PIMs occurred in over three-quarters of a population of older adults in residential care and was associated with a lower quality of life.  This study provides evidence to support that there is a need for greater adherence to recommendations for appropriate medication use in residential aged care.

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Section: Discussionmentioning

confidence: 99%

Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care

et al. 2018

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“…With respect to the ability to detect and reduce inappropriate prescribing, only seven studies described the application of set of explicit criteria as an intervention tool [7,9,12,[35][36][37][38]. Three of them considered the Beers criteria or variation [35][36][37], one study dealt with IPET (Inappropriate Prescribing in the Elderly Tool [39]) criteria [38], and three with STOPP/START.v1 [8,9,12].…”

Section: Discussionmentioning

confidence: 99%

“…Three of them considered the Beers criteria or variation [35][36][37], one study dealt with IPET (Inappropriate Prescribing in the Elderly Tool [39]) criteria [38], and three with STOPP/START.v1 [8,9,12]. Although all seven studies were positive, only the work conducted by Gallagher et al described an outcome measure of inappropriateness (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…This first version (v1) [4] has being increasingly used in Europe and is to some extend considered to be the ''European Beers criteria'' [6]. STOPP/START criteria have demonstrated a number of important properties as follows: STOPP criteria medications are significantly associated with ADEs [7]; STOPP/START criteria significantly improve medication appropriateness when applied at a single time point [8,9] and significantly reduced ADEs and average length of stay in older people hospitalized when applied within 72 h of admission [10]. A new edition of this screening tool was recently published [11].…”

Section: Introductionmentioning

confidence: 99%

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

Boland

Guignard

Dalleur

et al. 2016

European Geriatric Medicine

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“…Examples of resources include the Medication Appropriate Index (18), Beers criteria (11), Screening Tool of Older Person’s Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) (19, 20), and the Anticholinergic Burden Index (21). While these tools exist, no one tool is all inclusive or considered the gold standard.…”

Section: The Issuementioning

confidence: 99%

The Role of Pharmacists in Preventing Falls among America’s Older Adults

Karani

Haddad

Lee

2016

Front. Public Health

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Falls are the leading cause of both fatal and non-fatal injuries in people aged 65 years and older and can lead to significant costs, injuries, functional decline, and reduced quality of life. While certain medications are known to increase fall risk, medication use is a modifiable risk factor. Pharmacists have specialized training in medication management and can play an important role in fall prevention. Working in a patient-centered team-based approach, pharmacists can collaborate with the primary care providers to reduce fall risk. They can screen for fall risk, review and optimize medication therapy, recommend vitamin D, and educate patients and caregivers about ways to prevent falls. To help health-care providers implement fall prevention, the Centers for Disease Control and Prevention developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. Based on the established clinical guidelines, STEADI provides members of the health-care team, including pharmacists, with the tools and resources they need to manage their older patients’ fall risk. These tools are being adapted to specifically advance the roles of pharmacists in reviewing medications, identifying those that increase fall risk, and communicating those risks with patients’ primary care providers. Through a multidisciplinary approach, pharmacists along with other members of the health-care team can better meet the needs of America’s growing older adult population and reduce falls.

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Reduction of Potentially Inappropriate Medications Using the STOPP Criteria in Frail Older Inpatients: A Randomised Controlled Study

Cited by 125 publications

References 33 publications

Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care

Associations between the Drug Burden Index, Potentially Inappropriate Medications and Quality of Life in Residential Aged Care

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

The Role of Pharmacists in Preventing Falls among America’s Older Adults

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