Moderne Geriatrie und Akutmedizin

Hien, Peter; Pilgrim, Ralf Roger; Neubart, Rainer

doi:10.1007/978-3-642-25603-5

Cited by 7 publications

(10 citation statements)

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“…This can be explained by the accumulation of gait disturbances and falls integrated in criterion E5 as well as the high number of cardiovascular diagnoses (criteria A4 and A5). However, these are typical geriatric conditions, so that overall, it can be assumed that prehospital treatment with medication was good with regard to the most frequent omissions of medication [4]. In the cardiovascular system, only a small increase in medication during the treatment (7.8%) could be recorded.…”

Section: Discussionmentioning

confidence: 99%

“…Lower stimulability, lower tolerability, as well as a higher sensitivity of older patients to certain substances are significantly increased as more interactions have to be considered [3]. This often results in a significantly higher prevalence of adverse drug reactions (ADR) and a narrow therapeutic range [4]. The risk of ADR such as delirium, new onset of depression, falls, constipation, urinary incontinence, or parkinsonism was two to three times higher in patients over 65 years of age compared to younger patients [5].…”

Section: Background and Aim Of The Studymentioning

confidence: 99%

“…Lack of data on FEV1 led to this criterion being given as early as confirmed asthma/COPD diagnosis with described exacerbations under inhaled corticosteroid therapy [3,4].…”

Section: B2mentioning

confidence: 99%

“…Because no data of T-values regarding bone density were available, however these bone density values provide the basis of the respective disease according to WHO and ICD-10 (M80-85), these criteria were given on the basis of present medication for the existing diagnoses [4,11,30]. H1 Furthermore, since no indication or course of pain assessments was apparent in the diagnoses/doctor's letters and, in principle, no data from patient curves were available, the criterion had to be given if an administration of highly potent opioids had taken place for diagnosed pain, since it had to be assumed that this was necessary.…”

Section: E3 E4 E5mentioning

confidence: 99%

“…The largest decrease occurs with dopamine agonists followed by corticosteroids and beta-2 sympathimimetics. See table 4 for full details: For the START criteria, the statistical test using paired T-test for dependent measurements shows a highly significant difference of 0,65 per patient between admission and discharge (T=-6.57; p<.001), at discharge the value of fulfilled START criteria per patient is higher. According to Cohen [35], a small to approximately medium effect is described.…”

Section: Treatments Definition/adaptionmentioning

confidence: 99%

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Potentially inappropriate medication of community dwelling older patients in a geriatric day clinic using the START/STOPP criteria – a different way of application

Schubert

Gosch

Qureshi

et al. 2023

Preprint

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Aims: The aim of the study was to evaluate quality of drug prescribing during the stay in a geriatric day clinic using the START / STOPP version 2 criteria (START stands for Screen Tool to Alert doctors to Right Treatment, and STOPP stands for Screening Tool for Older Persons’ potentially inappropriatePrescriptions). Methods: The retrospective longitudinal study included 193 patients with the diagnoses pain and/or dementia and/or depression; assessment was conducted on admission and before discharge using a modified application of the START criteria focusing on actual implementation of START criteria. In parallel, STOPP criteria were specified with the help of information from patient information leaflets (PILs) and a German online pharma index. Results: Due to the administration of vitamin D and calcium, and increasing analgesic and antidepressant therapy, a highly significant mean increase (T=-6,57; p<.001) of 0.65 fulfilled START criteria per patient was observed during the treatment period. Regarding the fulfilment of STOPP criteria, the comparison of mean values shows a slight increase of 0.02 criteria per patient, which, however, is not significant (T=-.16; p=.875). Although a decrease of potentially inappropriate medication (PIM) could be achieved, no significant change was observed with regard to the STOPP criteria. The prevalence of PIM decreased from 82.9% on admission to 81.4% at discharge, whereas polypharmacy increased from 85.5% to 90.7%. The average number of diagnoses rose from 13.0 to 14.0 (T=-.16; p=.875). Both number of diagnoses and medications had a highly significant positive pearson correlation with implemented or fulfilled START /STOPP Criteria. This became particularly evident with the diagnoses of pain and depression. The increased quality of medicinal treatment is evident by (i) the high values of implemented STARTs, (ii) constant STOPPs with increasing medication during the treatment, and (iii) absolute growth in indicated STOPPs with a reduction in non-indicated medication. Conclusion: The quality of drug prescription is improved through utilizing START/STOPP criteria making them appropriate for optimizing pharmacotherapy; however, these criteria should be critically examined in the future with the help of the modified START methodology.

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Section: Discussionmentioning

confidence: 99%

Section: Background and Aim Of The Studymentioning

confidence: 99%

“…Lack of data on FEV1 led to this criterion being given as early as confirmed asthma/COPD diagnosis with described exacerbations under inhaled corticosteroid therapy [3,4].…”

Section: B2mentioning

confidence: 99%

Section: E3 E4 E5mentioning

confidence: 99%

Section: Treatments Definition/adaptionmentioning

confidence: 99%

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