Identification of Inappropriate Prescribing in Geriatrics at a Veterans Affairs Hospital Using STOPP/START Screening Tools
- 1 June 2010
- journal article
- Published by American Society of Consultant Pharmacists in The Consultant Pharmacist
- Vol. 25 (6), 365-373
- https://doi.org/10.4140/tcp.n.2010.365
Abstract
Pharmacists' interventions of potentially inappropriate medications (PIM) decrease hospital admissions and emergency department visits and provide health-cost savings. The newest criterion to address PIMs is STOPP/START (Screening Tool of Older Person's Prescriptions/Screening Tool to Alert Doctor's to the Right Treatment). The purpose of this study is to determine the frequency of PIMs in a geriatric population. A retrospective chart review of 511 patients was conducted at a Veterans Affairs hospital in patients > 70 years of age. Charts were reviewed at hospital admission, discharge, and first follow-up clinic visit post-discharge for incidence of STOPP/START medications. STOPP/START criterion was applied to patients' medication lists and documented with omission or commission medications. One hundred eleven (22%) patients met inclusion criteria. STOPP/START medication use was similar at all time points. Medications without an appropriate diagnosis were the most common type of STOPP criteria identified. Aspirin (> 150 mg daily) had high frequency of use. Incidence of START was highest with omissions of statin therapy, angiotensin-converting enzyme (ACE) inhibitor with heart failure, and vitamin D in patients with osteoporosis. The results demonstrated that inappropriate prescribing and omission of medications occurs consistently at all points of care. STOPP/START criteria are more comprehensive than previous inappropriate prescribing lists. Utilization of a clinical pharmacist would benefit patients through elimination of PIMs and identification of medications to optimize patient care.Keywords
This publication has 11 references indexed in Scilit:
- A Comprehensive Pharmacist Intervention to Reduce Morbidity in Patients 80 Years or OlderJAMA Internal Medicine, 2009
- Pharmacist-Based Medication Review Reduces Potential Drug-Related Problems in the ElderlyDrugs & Aging, 2009
- Pharmacists’ Interventions for Optimization of Medication Use in Nursing HomesDrugs & Aging, 2009
- Inappropriate Medications in the ElderlyClinical Pharmacology & Therapeutics, 2008
- STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteriaAge and Ageing, 2008
- The Anticholinergic Risk Scale and Anticholinergic Adverse Effects in Older PersonsArchives of Internal Medicine, 2008
- STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validationInternational journal of clinical pharmacology and therapeutics, 2008
- Potentially Inappropriate Prescribing for the ElderlyMedical Care, 2008
- Inappropriate prescribing in the older population: need for new criteriaAge and Ageing, 2008
- A Prescribing Cascade Involving Cholinesterase Inhibitors and Anticholinergic DrugsArchives of Internal Medicine, 2005