Key result
The STOPP/START criteria detected a higher rate of potentially inappropriate prescriptions compared with the Beers criteria (19.8% vs 7.3%) in elderly patients.
Why the study?
Does the STOPP/START criteria detect more potentially inappropriate prescriptions than the Beers criteria in patients aged ≥65 years?
Cross-Sectional (n=600)
Does the STOPP/START criteria detect more potentially inappropriate prescriptions than the Beers criteria in patients aged ≥65 years?
The STOPP/START criteria is more sensitive than the Beers criteria in detecting potentially inappropriate prescribing and prescribing omissions in elderly patients.
May warrant STOPP/START preference for PIP screening in elderly; leaves open outcome benefits versus Beers.
Between 25% and 40% of hospital admissions in elderly patients may be linked to drug-related problems. Therefore prevention and recognition of inappropriate prescribing of medicines in elderly patients is one of the principle health care quality and safety issues. To identify and compare the rate of inappropriate prescribing in elderly patients using two validated screening tools: STOPP/START criteria and Beers criteria. A cross-sectional observational study on prescriptions of 600 patients aged ≥65 years was conducted. STOPP/START criteria and Beers criteria were applied to detect inappropriate prescriptions. Feedback was obtained from clinicians about measures to reduce potentially inappropriate prescriptions (PIPs) and related adverse drug events. There were 19.8% and 7.3% PIPs found using STOPP/START criteria and Beers criteria, respectively. The most commonly found PIP with both criteria was the prescribing of calcium channel blockers among hypertensive patients with chronic constipation. Of the 19.8% PIPs found with STOPP/START criteria, 7% were potential prescribing omissions, the most common of which was statins not prescribed for diabetic patients with multiple cardiovascular risk factors. STOPP/START criteria detected more of PIPs in inpatients than outpatients. Polypharmacy and increasing age were important risk factors for PIPs. Most of the clinicians agreed that monitoring of adverse drug reactions would be helpful. The STOPP/START criteria detected more PIPs compared with the commonly used Beers criteria. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, hospital admissions, and cost.
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Karandikar et al. (2013) conducted a cross-sectional in Inappropriate prescribing (n=600). STOPP/START criteria vs. Beers criteria was evaluated on Rate of potentially inappropriate prescriptions (PIPs). The STOPP/START criteria detected a higher rate of potentially inappropriate prescriptions compared with the Beers criteria (19.8% vs 7.3%) in elderly patients.
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