Effectiveness of STOPP/START criteria in primary prevention of polypharmacy and under-treatment in older patients

Pala E., Ersoy S., Engin V. S., Benli A. R.

Therapies, cilt.77, ss.361-369, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 77
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.therap.2021.07.003
  • Dergi Adı: Therapies
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, BIOSIS, CAB Abstracts, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.361-369
  • Anahtar Kelimeler: STOPP, START criteria, Rational drug use, Primary care, Polypharmacy, Under-treatment, RISK-FACTORS, HEALTH-CARE, PEOPLE, ADULTS, PREVALENCE, STOPP
  • İstanbul Üniversitesi Adresli: Hayır

Özet

© 2021 Société française de pharmacologie et de thérapeutiqueAim of the study: STOPP/START criteria appear to be a useful tool to curb inappropriate prescribing (IP), which encompasses errors of both, over and under-treatment. This study aimed to find out whether application of STOPP/START reduces the IP effectively in primary care. Methods: This prospective cross-sectional study was conducted in two family health centers (FHCs) in Istanbul. All older adults who applied to FHCs between 01-07-2018 and 01-07-2020 were enrolled. The potential inappropriate medications (PIMs) and potential prescription omissions (PPOs) were identified according to STOPP/START version 2 criteria. Mean drug consumptions before and after STOPP/START were compared using Student's t-test. Results: Among 1023 participants there were 626 females and 397 males. The mean age was 73.33 ± 7.30 years. The number of the patients seen at FHCs was 657 (64.2%) while 366 (35.8%) of them were visited at home. Of the patients, 383 (37.8) were 75 years old or older and 631 (62.2%) of them were under 75. Overall number of drugs consumed per patient was 5.49 ± 3.93 while it was 6.01 ± 3.71 and 4.55 ± 4.138 for outpatients and home patients respectively (p < 0.001). By application of STOPP criteria, among the 5616 medications consumed by the overall patients, 881(%15.6) of them were found to be potentially inappropriate. 424 (41.4%) patients were using at least one PIM. This ratio was 354 (53.8%) in outpatients and 70 (19%) in home patients. START criteria identified 380 (%7.4) PPOs. There were 246 (24.0%) patients with at least with one PPO; 155 (42.3%) of whom were home patients and 91 (13.8%) were outpatients. Regarding the age groups; PIM ratio was 35.5% in patients under 75 and 52.1% over 75 whereas PPO ratio was 22.5% under 75 and 26.8% over 75. Conclusion: This study supports the data reporting the effectiveness of STOPP/START criteria in primary care units in implementing appropriate prescription criteria.