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

Abstract

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.

An evaluation of the appropriateness of prescribing and frailty in elderly patients using STOPP criteria and Frailty Index in tertiary care teaching hospital

“…The latest version 2 comprises of 80 indicators pertaining primarily to important drug-drug and drug-disease interactions and therapeutic duplication, arranged according to relevant physiological systems for ease of use. 8 In the present study, out of 60 prescriptions PIM was observed more in males which is comparable to the study done by Nagendra Vishwas et al 7 and PIM was observed more common in age group of 65-75 years (Figure 1) with mean age of 73.42 years which is like the study done by Kanagasanthosh et al 9 Polypharmacy defined as the regular use of five or more medications, is common among older adults. 10 It is an area of concern for elderly because of several reasons.…”

“…The global rate of PIM ranges from 12% to 40% and in our study rate of PIM prescriptions is 35% which is similar to study done by Gallagher et al 14 Among Indian studies, our rate of PIM was higher than the study done by Vishwas et al 7 (13.3%) and Murthy et al (21.01%). 8. The most common PIM is aspirin (n=6) and comparable results were seen in the studies done by Murthy et al 8 and Mathur et al 15 In the above studies, the most common diseases found in elderly patients are IHD, CVA, RHD and angina for which Aspirin is prescribed usually by physicians.…”

“…8. The most common PIM is aspirin (n=6) and comparable results were seen in the studies done by Murthy et al 8 and Mathur et al 15 In the above studies, the most common diseases found in elderly patients are IHD, CVA, RHD and angina for which Aspirin is prescribed usually by physicians. On the contrary, Vishwas et al reported Glibenclamide as most common PIM.…”