STOPP &amp; START criteria: A new approach to detecting potentially inappropriate prescribing in old age

O’Mahony, Denis; Gallagher, Paul; Ryan, Cristí­n; Byrne, Stephen; Hamilton, Hilary J.; Barry, Patrick; M, O'Connor; Kennedy, Julia

doi:10.1016/j.eurger.2010.01.007

Cited by 187 publications

(167 citation statements)

References 17 publications

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“…common amongst them are the Beers criteria-which consist of 53 medication classes that need to be avoided in elderly and the STOPP criteria -screening tool of older persons potentially inappropriate Prescriptions comprising of 65 medications, which must be avoided in elderly. 10,11 The goal of the American geriatric society revised Beers criteria-2012 was to improve care of elderly patients by reducing their exposure to Potentially inappropriate medications. 12 Early detection of a potentially inappropriate medication can prevent adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Drug prescribing patterns in elderly patients in a tertiary level hospital

Bhaveshaikh

Sukumaran

Vyas

2017

Int J Basic Clin Pharmacol

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Background: Elderly people have multiple co morbidities and are often prescribed potentially inappropriate medications (PIMs). As there is paucity of information about the prescribing practices in elderly this study was undertaken to assess drug utilization patterns in elderly patients.Methods: A prospective observational study was conducted in a tertiary care hospital. A total of 576 prescriptions of elderly patients were included in the study. Prescribing patterns among elderly patients attending OPD and admitted to wards of departments of Medicine, Psychiatry, Dermatology, Pulmonary Medicine, General Surgery, E.N.T., Ophthalmology, Orthopaedics, Obstetrics and Gynaecology were analysed using the prescribing indicators (WHO criteria). The PIMs were identified as per the Beers 2012 criteria.Results: The average number of drugs per patient was 3.91±1.93 for O.P.D and 7.37 ±2.22 for I.P.D. patients. 37.76% patients in I.P.D. and 26.87% patients in O.P.D. received a medication which was potentially inappropriate as per Beers 2012 criteria. 7.58% (234/3088) of total medications prescribed to patients in the study were potentially inappropriate. There was a significant increase in the number of PIMs (p value ˂0.05) as the total number of drugs prescribed increased.Conclusions: Educational programmes are needed to reinforce rational prescribing by physicians and precautions should be taken while prescribing potentially inappropriate drugs to elderly patients.

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Section: Introductionmentioning

confidence: 99%

Drug prescribing patterns in elderly patients in a tertiary level hospital

Bhaveshaikh

Sukumaran

Vyas

2017

Int J Basic Clin Pharmacol

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“…Beer's criteria, Phadke's criteria and Screening Tool of Older Person's potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to the Right Treatment (START) criteria are a few among the list. [4][5][6][7][8][9][10][11] Beer's criteria, the most popular tool for studies on geriatric prescribing, has limitations like less importance being given to under use of drugs, drug interactions and therapeutic duplication. 3 On the other hand, STOPP comprises of 80 indicators pertaining primarily to important drug-drug and drugdisease interactions and therapeutic duplication.…”

Section: Introductionmentioning

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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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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“…These highly cited, updated Beers' criteria and subsequent variations of them have formed the basis for tools that aim to improve medication safety by measuring the risk and minimizing drug related problems in older people [O'Mahony and Gallagher, 2008;Rudd et al 2005]. The Screening Tool for Older Persons' Prescriptions (STOPP) and the Screening Tool to Alert Right Treatment (START) criteria have been developed and validated for European countries with results that indicate they are more sensitive to detecting ADE and prescription errors than the Beers' criteria [O'Mahony et al 2010;Delgado Silveira et al 2009;Lang et al 2009;Ryan et al 2009;Gallagher et al 2008;Topinkova et al 2008]. The Drug Burden Index (DBI) is another risk assessment tool that identifies high-risk medicines by pharmacologic class (anticholinergic and sedative) and calculates an individual's cumulative exposure to these medicines, considering both the number and dose of these medicines [Hilmer et al 2007a].…”

Section: Risk Assessment Toolsmentioning

confidence: 99%

Medication safety in residential aged-care facilities: a perspective

Wilson

March

Sambrook

et al. 2010

Therapeutic Advances in Drug Safety

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Medication safety must be tailored to the distinctive issues in residential aged-care facilities (RACFs). The health and functional characteristics of their residents are different to those of hospital inpatients and community-dwelling older adults, and there are unique staffing and management issues. Understanding the aetiology and epidemiology of drug-related problems is vital in developing methods to improve patient safety. In this perspective review, we discuss tools that are used to quantify exposure to 'high-risk' medications and their evaluation in residential aged-care settings. Drug withdrawal interventions are described as a potential way to reduce adverse drug events in RACFs. Multidisciplinary professional interventions, education programs and improved communication between health professionals have been shown to improve medication safety in RACFs. Technological advances and other administrative strategies may also improve resident safety. This perspective addresses issues in medication safety facing RACFs and methods to improve the safety of medicines for their residents.

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STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age

Cited by 187 publications

References 17 publications

Drug prescribing patterns in elderly patients in a tertiary level hospital

Drug prescribing patterns in elderly patients in a tertiary level hospital

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

Medication safety in residential aged-care facilities: a perspective

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