Inter-rater reliability of STOPP (Screening Tool of Older Persons’ Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria amongst physicians in six European countries

Abstract

SIR—Inappropriate prescribing (IP) encompasses the use of medicines where the risk of an adverse drug event (ADE) outweighs the clinical benefit, particularly when safer or more effective alternatives are available [ 1, 2 ]. IP also includes the use of medicines that increase the likelihood of drug–drug and drug–disease interactions, the mis-prescribing of medicines (incorrect dose, frequency and duration) and the under-use of clinically indicated medicines [ 3–5 ]. IP is highly prevalent in older people and has been associated with preventable ADEs, hospitalisation, institutionalisation, death and resource wastage [ 6–12 ]. With increasing proportions of older people worldwide, quality and safety of prescribing are becoming a global healthcare concern [ 5 , 13 ].