Evaluation of rationality of geriatric patients prescription based on STOPP/START criteria in a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20243831Keywords:
Potentially inappropriate prescription, Potentially inappropriate medication, Potential prescription omissionAbstract
Background: The geriatric population (65 years and above) is a challenge to treat for the medical fraternity, exposing them to the risk of potentially inappropriate prescription (PIP) and thus, increasing the risk of adverse drug reactions (ADR). The over-use of drugs and irrational choice lead to the prescription of a potentially inappropriate medication (PIM) and the underuse of appropriate drugs leading to potential prescribing omission (PPO). Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to the Right Treatment (START) criteria is one of the most effective tools to check the rationality of the prescribed drugs.
Methods: The study was a six-month (March 2023 to August 2023) prospective observational design. A total of 193 patients were enrolled in the study. Case report forms were used to confirm the diagnosis and medications. Geriatric patients who fulfilled the study inclusion criteria were assessed using the STOPP/START toolkit version 2.
Results: The majority of the study participants belonged to age group 65 to 70 years. Out of these 40.4% of the study participants had Potentially Inappropriate Medications based on STOPP criteria and 31.1% had Potential Prescription Omissions based on START criteria.
Conclusions: Potentially Inappropriate Prescriptions were assessed using STOPP/START criteria in version 2. A high prevalence of PIM and PPO was found. Co-morbidity and polypharmacy were linked to a higher chance of PIM. Thus, this criterion can be used to generate rational prescriptions for the elderly population.
Metrics
References
Kara Ö, Arık G, Kızılarslanoglu MC, Kılıc MK, Varan HD, Sümer F, et al. Potentially inappropriate prescribing according to the STOPP/START criteria for older adults. Aging Clin Exper Res. 2016;28:761-8.
O'Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age and ageing. 2008;37(2):138-41.
Nations U. Department of economic and social affairs, population division. World population prospects: the 2017 revision, key findings and advance tables. in Working Paper No ESA/P/WP/248. 2017: 46.
Cruz-Jentoft AJ, Boland B, Rexach L. Drug therapy optimization at the end of life. Drugs Aging. 2012;1;29(6):511-21.
Hanlon JT, Schmader KE, Ruby CM, Weinberger M. Suboptimal prescribing in older inpatients and outpatients. J Am Geriatr Soc. 2001;49(2):200-9.
Reason B, Terner M, Moses McKeag A, Tipper B, Webster G. The impact of polypharmacy on the health of Canadian seniors. Fam Pract. 2012;29(4):427-32.
Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet. 2007;14:173-84
Konrat C, Boutron I, Trinquart L, Auleley GR, Ricordeau P, Ravaud P. Underrepresentation of elderly people in randomised controlled trials. The example of trials of 4 widely prescribed drugs. PLoS One. 2012;7(3):33559.
O'Connor MN, Gallagher P, O'Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging. 2012;29(6):437-52.
Patel MM, Mark AS, Shah NA. Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START criteria version 2 at a tertiary care teaching hospital. Natl J Physiol Pharm Pharmacol. 2022;12(10):1746-50.
Barry PJ, Gallagher P, Ryan C, O'mahony D. START (screening tool to alert doctors to the right treatment) --an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing. 2007;36(6):632-8.
Hill-Taylor B, Sketris I, Hayden J, Byrne S, O'Sullivan D, Christie R. Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults and evidence of clinical, humanistic and economic impact. J Clin Pharm Ther. 2013;38(5):360-72.
Murthy MB, Jagtap K, Burute SR, Ramanand SJ, Pore SM, Patil PT. Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario. Int J Basic Clin Pharmacol. 2017;6(12):2864-70
Bo M, Gibello M, Brunetti E, Boietti E, Sappa M, Falcone Y, et al. Prevalence and predictors of inappropriate prescribing according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria in older patients discharged from geriatric and internal medicine wards: A prospective observational multicenter study. Geriatr Gerontol Int. 2019;19(1):5-11.