STOPP (Screening Tool of Older Persons Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation

Gallagher, Paul; Ryan, Cristí­n; Byrne, Stephan; Kennedy, Julia; O’Mahony, Denis

doi:10.5414/cpp46072

Cited by 1,258 publications

(1,001 citation statements)

References 0 publications

Supporting

Mentioning

917

Contrasting

Unclassified

Order By: Relevance

“…The START and STOP criteria were applied to a certain extent, although not systematically. (252) In patients using diuretics the diuretic was removed if the treatment indication was weak or absent, or if the patients suffered from side-effects as orthostatic hypotension and/or urinary incontinence. If indicated, patients with long-lasting anxiety or depression could be offered specific treatment of their disorders if considered potentially beneficial.…”

Section: The Intervention Arm (Experimental)mentioning

confidence: 99%

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

et al. 2015

View full text Add to dashboard Cite

Bakgrunn: Hoftebrudd er en viktig årsak til sykdom og død med 1.3 millioner brudd årlig i verden og en fortsatt stigende insidens. Risikofaktorer er høy alder, osteoporose og skrøpelighet, og de fleste bruddene skyldes lav energitraumer på grunn av fall. Høy alder, nedsatt funksjon før bruddet og mannlig kjønn øker risiko for et uheldig resultat, mens fall utendørs er prognostisk gunstig.Utvikling av såkalt ortogeriatriske behandlingsmodeller for hoftebrudd som bruker teknikker og prinsipper utviklet i geriatrien er en måte å bedre prognosen for pasientene. Det er utviklet flere modeller:1. Konsultasjonsmodeller der pasienten på vanlig måte behandles i en ortopedisk avdeling, men får tilsyn og vurdering av geriater eller et geriatrisk team under oppholdet, og der teamet deretter foreslår tiltak til ortoped. 2. Modeller med felles ansvar der geriater og ortoped inngår i et team som utreder og behandler pasienten og legger en felles plan for videre oppfølging. 3. Geriatrisk team modeller der utredning og behandling (med unntak av selve kirurgien)foregår i en geriatrisk avdeling tilpasset bruddbehandling, og der ortopeder ansvarlig for operasjon, men ellers kun konsulteres ved behov. Målsetninger for studien: Overordnet mål for studien var å undersøke om bred geriatrisk utredning og behandling (CGC) ga en tilleggsgevinst sammenlignet med tradisjonell ortopedisk behandling (OC).Målsetninger for denne avhandlingen er:1. Å beskrive bakgrunn, utvikling og prinsippene bak de orthogeriatriske modellen og hvordan den skiller seg fra vanlig behandling (Artikkel I). 2. Å presentere kliniske resultat (Artikkel II): a. Mobilitet fire måneder etter bruddet (primaert endepunkt) b. Sekundaere endepunkt: i. Mobilitet etter en og 12 måneder, og p-i-ADL, kognisjon, frykt for å falle, stemningsleie og livskvalitet en, fire og 12 måneder etter bruddet, ii. Bruk av helsetjenester første året etter bruddet 3. Finne ut om effekten på mobilitet, p-og-i-ADL og kognisjon var avhengig av alder, kjønn, bruddtype og funksjon før bruddet (Artikkel III).Metode: Hoftebruddsstudien i Trondheim er en randomisert kontrollert studie basert på ortogeriatrimodell 3 ovenfor. Studien sammenligner standard ortopedisk behandling (OC) med ortogeriatrisk behandling i en egen enhet (CGC). Hjemmeboende pasienter 70 år eller eldre som klarer å gå minst 10m og som har et lavenergibrudd kunne inkluderes, mens pasienter fra sykehjem, høy-energi brudd, patologisk fraktur eller annen sykdom med forventede leveutsikter på mindre enn 3 måneder ble ekskludert. Behandlingen er basert på bred geriatrisk utredning (CGA) og gjennomføres av et tverrfaglig team bestående av geriater (overlege eller lege i spesialisering), sykepleier, fysioterapeut og ergoterapeut; teamet har regelmessige møter der det lages individuelle behandlingsplaner og settes mål for opphold og klargjør videre behov etter utreise samt behandlingsmål. Behandlingen er helhetlig og fokuserer på tidlig mobilisering, gjennomgang av den enkelte pasient med tanke på bakenforliggende sykdom, medisingjennomgang...

show abstract

Section: The Intervention Arm (Experimental)mentioning

confidence: 99%

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The START list of potential errors of prescribing omission has been formulated specifically for use in tandem with STOPP [5] to give a more complete assessment of potential IP in older people. In the present study, 22.7% of patients had one or more clinically indicated medicines omitted from their regular prescriptions without valid reasons.…”

Section: Discussionmentioning

confidence: 99%

“…STOPP and START were formulated and validated to address the perceived deficiencies of Beers' criteria [5]. STOPP, which is based on physiological systems, contains a list of 65 explicit rules for avoidance of certain drugs/drug classes.…”

Section: Introductionmentioning

confidence: 99%

“…Other tools including The Improving Prescribing in the Elderly Tool [2], The Medication Appropriate Index [3], Beers' criteria [4], and Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) [5] have also been developed to identify PIMs and PPOs in older people. A recent review by Laroche et al examining the strengths and weakness of inappropriate prescribing (IP) screening tools endorses the use of STOPP and START and highlights important deficiencies of Beers' criteria in the European context [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Potentially inappropriate prescribing in an Irish elderly population in primary care

Ryan¹,

O’Mahony

Kennedy³

et al. 2009

Brit J Clinical Pharma

249

251

View full text Add to dashboard Cite

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Potentially inappropriate prescribing in older people is a well‐documented problem and has been associated with adverse drug reactions and hospitalization.• Beers' criteria, Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) are screening tools that have been formulated to help physicians and pharmacists identify potentially inappropriate prescribing and potential prescribing omissions.• The prevalence of potentially inappropriate prescribing and prescribing omissions in the elderly population presenting to hospital with acute illness is high according to STOPP and START criteria. WHAT THIS STUDY ADDS • Potential errors of prescribing and of omission of medicines are prevalent among medically stable older people in primary care.• Screening tools should be incorporated into the everyday practice of primary care doctors and community pharmacists as a means of preventing potential errors of prescribing commission and prescribing omission in older people.AIMS Screening tools have been formulated to identify potentially inappropriate prescribing (IP) in older people. Beers' criteria are the most widely used but have disadvantages when used in Europe. New IP screening tools called Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) have been developed to identify potential IP and potential prescribing omissions (PPOs). The aim was to measure the prevalence rates of potential IP and PPOs in primary care using Beers' criteria, STOPP and START.METHODS Case records of 1329 patients ≥65 years old from three general practices in one region of southern Ireland were studied. The mean age ± SD of the patients was 74.9 ± 6.4 years, 60.9% were female. Patients' current diagnoses and prescription medicines were reviewed and the Beers' criteria, STOPP and START tools applied.RESULTS The total number of medicines prescribed was 6684; median number of medicines per patient was five (range 1–19). Overall, Beers' criteria identified 286 potentially inappropriate prescriptions in 18.3% (243) of patients, whilst the corresponding IP rate identified by STOPP was 21.4% (284), in respect of 346 potentially inappropriate prescriptions. A total of 333 PPOs were identified in 22.7% (302) of patients using the START tool.CONCLUSION Potentially inappropriate drug prescribing and errors of drug omission are highly prevalent among older people living in the community. Prevention strategies should involve primary care doctors and community pharmacists.

show abstract

“…12 Een voorbeeld van expliciete criteria zijn de STOPP-START-criteria [kader]. 13 Ook expliciete criteria zijn niet altijd van toepassing op iedere individuele patiënt en daarom kan beargumenteerd afwijken wenselijk zijn. 7 Er is nog niet eerder onderzocht in welke mate FTP's die men door middel van een impliciete screeningsmethode heeft opgespoord ook gevonden hadden kunnen worden met behulp van expliciete STOPP-START-criteria.…”

Section: Optimaliseren Geneesmiddelengebruik Door Ouderenunclassified

Optimaliseren geneesmiddelengebruik door ouderen

Kwint

Faber²,

Gussekloo³

et al. 2015

HUISARTS WETENSCHAP

View full text Add to dashboard Cite

macotherapiegerelateerde problemen (FTP's), zoals onder-en overbehandeling, niet-effectieve behandeling, (risico op) bijwerkingen en interacties, beveelt de richtlijn ook aan aandacht te besteden aan ordeningsproblemen. 6,8 Er is sprake van een ordeningsprobleem als de patiënt problemen ervaart bij het overzicht, beheer en inname van zijn geneesmiddelen. [8][9][10] Deze patiënten kunnen worden ondersteund door het verpakken van de geneesmiddelen in geïndividualiseerde distributievormen (GDV's) [figuur 1], zoals medicatie op rol ('Baxter').Het proefschrift Improving appropriate medication use for older people in primary care bevat verschillende onderzoeken naar het optimaliseren van de kwaliteit van het geneesmiddelengebruik bij ouderen in de eerste lijn. 14 Het gaat vooral in op effecten van medicatiebeoordeling, waarbij we een aantal onderzoeken hebben uitgevoerd onder ouderen die gebruikmaken van medicatie op rol. MedicatiebeoordelingMedicatiebeoordeling beoogt de farmacotherapeutische be- ▪ Gebruikers van medicatie op rol rapporteren een hoge therapietrouw en een lage medicatiekennis. Bij deze gebruikers zien we relatief veel farmacotherapiegerelateerde problemen.

show abstract

STOPP (Screening Tool of Older Persons Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation

Cited by 1,258 publications

References 0 publications

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

Potentially inappropriate prescribing in an Irish elderly population in primary care

Optimaliseren geneesmiddelengebruik door ouderen

Contact Info

Product

Resources

About

STOPP (Screening Tool of Older Persons Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation

Cited by 1,258 publications

References 0 publications

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

Potentially inappropriate prescribing in an Irish elderly population in primary care

Optimaliseren geneesmiddelengebruik door ouderen

Contact Info

Product

Resources

About

STOPP (Screening Tool of Older Persons Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation