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Current Aging Science

Editor-in-Chief

ISSN (Print): 1874-6098
ISSN (Online): 1874-6128

Research Article

STOPP-START Criteria Used to Identify the Elderly Population Prone to Potentially Inadequate Prescribing in a Colombian Cohort

Author(s): Loren Zambrano, Rosa-Helena Bustos*, Edgar Beltran, Daniel Gomez, Sara Arias and Wilson Briceño

Volume 17, Issue 2, 2024

Published on: 16 January, 2024

Page: [135 - 143] Pages: 9

DOI: 10.2174/0118746098274486231227101704

Price: $65

Abstract

Background: Elderly people have multiple comorbidities that often require treatment with multiple medications. Having strategies to lessen the risks associated with pharmacological interactions and potentially inadequate prescribing (PIP) is of major importance. The STOPP– START criteria are useful in identifying PIP along with other tools, such as LASA (look alike/sound alike) drugs and high-risk medications (HRM).

Objective: We aimed to clinically and sociodemographically characterize the population with PIP according to the STOPP–START criteria in hospitalized elderly patients over 6 months in a third-level hospital in Colombia, South America. We also aimed to calculate the prevalence of PIP, LASA drugs and HRM and to identify other problems related with medication. Finally, we proposed an algorithm for the identification of PIP in this population.

Methods and Materials: This was a descriptive, cross-sectional study in hospitalized patients older than 60 years during the first semester of 2021 to identify PIP according to STOPP– START criteria. An analysis of clinical and sociodemographic variables was conducted, as well as the construction of an algorithm to identify PIP in the elderly in a semiautomated way. Data were collected and analyzed using the software SPSS 2021, using descriptive statistics and measures of central tendency.

Results: The prevalence of PIP in the study population was 25%. Furthermore, 60% of patients had one problem related to medication, and 27% used at least one LASA drug or HRM.

Conclusion: This study allows one to characterize, for the first time, the Colombian population prone to PIP, as well as the construction of an algorithm that identifies PIP in a semiautomated way.

Graphical Abstract

[1]
Cahir C, Bennett K, Teljeur C, Fahey T. Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients. Br J Clin Pharmacol 2014; 77(1): 201-10.
[http://dx.doi.org/10.1111/bcp.12161] [PMID: 23711082]
[2]
Filié Haddad M, Satie Takamiya A, Martins da Silva EM, Barros Barbosa D. Pharmacology in the elderly: Medications for continuous use and dangers of drug interaction. Gerokomos 2009; 20(1): 22-7.
[http://dx.doi.org/10.4321/S1134-928X2009000100004]
[3]
Frankenthal D, Lerman Y, Kalendaryev E, Lerman Y. Potentially inappropriate prescribing among older residents in a geriatric hospital in Israel. Int J Clin Pharm 2013; 35(5): 677-82.
[http://dx.doi.org/10.1007/s11096-013-9790-z] [PMID: 23661173]
[4]
Akbari A, Mirakhori F, Ashouri M, Nehzat Norozi Tehrani S. The effect of micronutrient intake on cognitive function and physical activity of the elderly. Int J Sport Stud Heal 2022; 4(1): 1.
[http://dx.doi.org/10.5812/intjssh.121360]
[5]
Gallo A, Vilosio JO, Saimovici J. Update of the STOPP-START criteria: A tool for the detection of potentially inappropriate medication in the elderly. Evid Update Ambulat Pract 2016; 18(4): 1-6.
[6]
Terán-Álvarez L, González-García MJ, Rivero-Pérez AL, Alonso-Lorenzo JC, Tarrazo-Suárez JA. Potentially inappropriate prescription in older, polymedicated patients according to “STOPP” criteria. Semergen 2016; 42(1): 2-10.
[http://dx.doi.org/10.1016/j.semerg.2014.10.018]
[7]
Pardo-Cabello AJ, Bermudo-Conde S, Manzano-Gamero V. Potentially inappropriate prescription in hospitalized patients with a comparative study between the prescription and that carried out by internists and geriatricians. Farm Hosp 2014; 38(1): 65-8.
[PMID: 24483862]
[8]
Puche Cañas E, Luna del Castillo JD. Reacciones adversas a medicamentos en pacientes que acudieron a un hospital general: Un meta-análisis de resultados. An Med Interna 2007; 24(12): 574-8.
[http://dx.doi.org/10.4321/S0212-71992007001200003] [PMID: 18278994]
[9]
Barry PJ, O’Keefe N, O’Connor KA, O’Mahony D. Inappropriate prescribing in the elderly: A comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients. J Clin Pharm Ther 2006; 31(6): 617-26.
[http://dx.doi.org/10.1111/j.1365-2710.2006.00783.x] [PMID: 17176367]
[10]
O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2. Age Ageing 2014; 44(2): 213-8.
[http://dx.doi.org/10.1093/ageing/afu145] [PMID: 25324330]
[11]
O’Mahony D. STOPP/START criteria for potentially inappropriate medications/potential prescribing omissions in older people: Origin and progress. Expert Rev Clin Pharmacol 2020; 13(1): 15-22.
[http://dx.doi.org/10.1080/17512433.2020.1697676] [PMID: 31790317]
[12]
Delgado Silveira E, Montero Errasquín B, Muñoz García M, et al. Improving drug prescribing in the elderly: A new edition of STOPP/START criteria. Rev Esp Geriatr Gerontol 2015; 50(2): 89-96.
[http://dx.doi.org/10.1016/j.regg.2014.10.005] [PMID: 25466971]
[13]
O’Connor MN, O’Sullivan D, Gallagher PF, Eustace J, Byrne S, O’Mahony D. Prevention of hospital‐acquired adverse drug reactions in older people using screening tool of older persons’ prescriptions and screening tool to alert to right treatment criteria: A cluster randomized controlled trial. J Am Geriatr Soc 2016; 64(8): 1558-66.
[http://dx.doi.org/10.1111/jgs.14312] [PMID: 27365262]
[14]
Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther 2008; 46(2): 72-83.
[http://dx.doi.org/10.5414/CPP46072] [PMID: 18218287]
[15]
Dalton K, O’Sullivan D, O’Connor MN, Byrne S, O’Mahony D. Prevention of adverse drug reactions in hospitalized older patients. Physician versus pharmacist. Innov Aging 2017; 1 (Suppl. 1): 433-4.
[http://dx.doi.org/10.1093/geroni/igx004.1555]
[16]
Australian Commision on Safety and Quality in Healthcare. National Tall Man Lettering List 2020. Available from: https://www.safetyandquality.gov.au/sites/default/files/2020-12/national_tall_man_lettering_list_-_dec_2020_pdf.pdf
[17]
Filik R, Purdy K, Gale A, Gerrett D. Drug name confusion: Evaluating the effectiveness of capital ("Tall Man") letters using eye movement data. Soc sci med 2004; 59(12): 2597-601.
[18]
US Food and Drug Administration (FDA), Institute for Safe Medication Practices (ISMP). Lists of Look-Alike Drug Names with Recommended Tall Man Letters 2023. Available from: https://www.ismp.org/recommendations/tall-man-letters-list
[19]
Cohen MR, Smetzer JL, Tuohy NR, Kilo CM. High-Alert Medications: Safeguarding against Errors 2nd Ed;. American Pharmacist Association 2007.
[20]
Cotrina Luque J, Guerrero Aznar MD, Alvarez del Vayo Benito C, Jimenez Mesa E, Guzman Laura KP, Fernández Fernández L. Model list of high-risk medications. An Pediatr 2013; 79(6): 360-6.
[http://dx.doi.org/10.1016/j.anpedi.2013.04.026] [PMID: 23746740]
[21]
Ministry of Health. Technical guide “Good practices for patient safety in health care” 2015. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/CA/seguridad-en-la-utilizacion-de-medicamentos.pdf
[22]
Grupo de Investigación en Atención Farmacéutica (Universidad de Granada). Third Granada consensus on medication-related problems (PRM) and negative outcomes associated with medication (RNM). Ars Pharm 2007; 48(1): 5-17.
[23]
University of La Sabana Clinic. Instructions for the correct labeling of medications and medical devices 2023.
[24]
Council of International Organizations of Medical Sciences, Pan American Health Organization. International ethical guidelines for health-related research involving human subjects 2017. Available from: https://iris.paho.org/handle/10665.2/34457
[26]
Rivera Plaza L. Inappropriate drug prescription and its relationship with therapeutic compliance in polymedicated patients. Gerokomos 2018; 29: 123-7.
[27]
Candela Marroquín E, Mateos Iglesia N, Palomo Cobos L. Adequacy of pharmaceutical prescription in people aged 65 years or older in teaching health centers in Cáceres. Rev Esp Salud Pública 2012; 86(4): 419-34.
[PMID: 23076087]
[28]
Cruz-Esteve I, Marsal-Mora JR, Galindo-Ortego G, et al. Potentially inappropriate prescribing in older Spanish population according to STOPP/START criteria (STARTREC study). Aten Primaria 2017; 49(3): 166-76.
[http://dx.doi.org/10.1016/j.aprim.2016.02.013] [PMID: 27693033]
[29]
Martín Lesende I, Mendibil Crespo I, Maiz López G, Gabilondo Zelaia I, Aretxabaleta Parra JC, Mota Goicoechea A. Potentiality of STOPP/START criteria used in primary care to effectively change inappropriate prescribing in elderly patients. Eur Geriatr Med 2013; 4(5): 293-8.
[http://dx.doi.org/10.1016/j.eurger.2013.06.006]
[30]
Álpizar Cortes JE, Angeles Lozano KL, Ávila Ballesteros D, et al. Identification of potential drug interactions in geriatric patients. J Negat No Posit Resul 2020; 5: 998-1009.
[31]
Lizarazo J, Daza D, Parrado Y. Pharmacotherapy follow-up as a tool for minimization of risk derivated from negative outcomes related to medication in elderly patients. Bogotá-Colombia Tercer Congreso Colombiano de Atención Farmacéutica.
[32]
Bryan R, Aronson JK, Williams AJ, Jordan S. A systematic literature review of LASA error interventions. Br J Clin Pharmacol 2021; 87(2): 336-51.
[http://dx.doi.org/10.1111/bcp.14644] [PMID: 33197079]
[33]
Fajreldines A, Insua J, Schnitzler E. Prevalence of potentially inappropriate medication prescribing in older adults. Rev Calid Asist 2016; 31(5): 279-84.
[http://dx.doi.org/10.1016/j.cali.2015.12.009] [PMID: 26970837]
[34]
García Orihuela M, Suárez Martínez R, Pérez Hernández B. STOPP-START criteria and inappropriate prescription for the elderly. Rev Habanera Cienc Méd 2020; 19.
[35]
Mud F, Mud S, Rodriguez MJ, Ivorra MD, Ferrandiz ML. Detection of potentially inappropriate prescriptions in elderly patients: descriptive study in two community pharmacies. Farm Com 2014; 6(2): 20-6.
[36]
Mekonnen AB, Redley B, de Courten B, Manias E. Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis. Br J Clin Pharmacol 2021; 87(11): 4150-72.
[http://dx.doi.org/10.1111/bcp.14870] [PMID: 34008195]
[37]
Santos NS, Marengo LL, Moraes FDS, Barberato-Filho S. Interventions to reduce the prescription of inappropriate medicines in older patients. Rev Saude Publica 2019; 53: 7.
[http://dx.doi.org/10.11606/S1518-8787.2019053000781] [PMID: 30726488]

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