A Systematic Review of Studies of the STOPP/START 2015 and American Geriatric Society Beers 2015 Criteria in Patients ≥ 65 Years

Abstract

Background: Polypharmacy remains problematic for individuals ≥65. Objective: To summarise the percentages of patients meeting 2015 STOPP criteria for Potentially Inappropriate Prescriptions (PIPs), 2015 Beers criteria for Potentially Inappropriate Medications (PIMs), and START criteria Potential Prescribing Omissions (PPOs). Methods: Searches conducted on 2 January 2019 in Medline, Embase, and PubMed identified 562 studies and 62 studies were retained for review. Data were abstracted independently. Results: 62 studies (n=1,854,698) included two RCTs and 60 non-randomised studies. For thirty STOPP/START studies (n=1,245,974) average percentages for ≥1 PIP weighted by study size were 42.8% for 1,242,010 community patients and 51.8% for 3,964 hospitalised patients. For nineteen Beers studies (n = 595,811) the average percentages for ≥1 PIM were 58% for 593,389 community patients and 55.5% for 2,422 hospitalised patients. For thirteen studies (n=12,913) assessing both STOPP/START and Beers criteria the average percentages for ≥1 STOPP PIP were 33.9% and Beers PIMs 46.8% for 8,238 community patients, and for ≥ 1 STOPP PIP were 42.4% and for ≥1 Beers PIM 60.5% for 4,675 hospitalised patients. Only ten studies assessed changes over time and eight found positive changes. Conclusions: PIP/PIM/PPO rates are high in community and hospitalised patients in many countries. RCTs are needed for interventions to: reduce new/existing PIPs/PIMs/PPO prescriptions, reduce prescriptions causing adverse effects, and enable regulatory authorities to monitor and reduce inappropriate prescriptions in real time. Substantial differences between Beers and STOPP/START assessments need to be investigated whether they are due to the criteria, differential medication availability between countries, or data availability to assess the criteria.

Health profile of residents of retirement villages in Auckland, New Zealand: findings from a cross-sectional survey with health assessment

“…Consideration might be given to include some of these more specifically in the interRAI assessment, especially those contributing to clinical management of chronic symptoms, or, for example, potentially inappropriate prescribing. 34 That 19% of residents described themselves as providing daily support for others suggests that investigating the interdependence between those who cohabit may be justified, to inform the need for formal care services should one partner no longer be able to assist.…”

Title Assessing Potentially Inappropriate Medications in Seniors: Differences between American Geriatrics Society and STOPP Criteria, and Preventing Adverse Drug Reactions

“…"Potentially inappropriate medications" (PIMs) and "potential prescribing omissions" (PPOs) are key problems for older patients with multiple illnesses. A systematic review of 62 studies (n = 1,854,698) according to the Screening Tool of Older People's Prescriptions (STOPP) [1] criteria found 42.8% of community dwelling individuals and 51.8% of hospitalised patients ≥65 had ≥one PIM and according to the AGS Beers [2] criteria, 58% and 55.5%, respectively, and many patients had multiple PIMs and PPOs [3]. A key issue is how to prevent prescription of PIMs and PPOs in the first place and then to deprescribe existing PIMs and PPOs to reduce the risk of adverse drug events (ADRs).…”

Multimorbidity patterns in chronic older patients, potentially inappropriate prescribing and adverse drug reactions: protocol of the multicentre prospective cohort study MoPIM

“…In recent years, many studies have been published using the STOPP-START criteria to assess the adequacy of medications in the community, socio-health centres and/or nursing homes, and the hospital setting 14 18 22–28. At the time of initiating this study, no published analyses were available with the objective to describe the relationships between multimorbidity, PIP and ADRs.…”