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International Journal of Clinical Pharmacy

, Volume 41, Issue 6, pp 1562–1569 | Cite as

Patients’ clinical information requirements to apply the STOPP/START criteria

  • Rosário Carvalho
  • Marta Lavrador
  • Ana C. Cabral
  • Manuel T. Veríssimo
  • Isabel V. Figueiredo
  • Fernando Fernandez-Llimos
  • M. Margarida Castel-BrancoEmail author
Research Article
  • 86 Downloads

Abstract

Background The STOPP/START criteria are an explicit tool to detect potentially inappropriate medications (PIMs). Patient clinical information may not be available in all settings. Objective To identify patient clinical information needed to apply the STOPP/START criteria. Setting: Four nursing homes in Portugal. Methods First, a theoretical analysis was performed to identify the patient information required to apply the STOPP/START criteria (v2), according to the following categories: patients’ current medication, medication history (previous medication and duration), medical records (current and past medical conditions), and laboratory test results. A verification of the information requirements was conducted through a cross-sectional study on a nursing home population with patients over 65 years old. Patients’ medical records were appraised to extract only demographic data and current medication profiles. Main outcome measure Information requirements of STOPP/START. Results For only 29 of the 81 STOPP criteria and 1 of the 34 START criteria, a judgement could be made with only the information in the patient’s medication profile. 52 STOPP and 33 START criteria require additional information, (i.e. duration of therapy, previous medication, current and past medical conditions, and laboratory data). The 208 evaluated persons (87 years; 68.75% female) used 1770 medications, with 989 (55.9%) potentially involved in 1629 STOPP criteria. Sufficient information to judge STOPP criteria was available for only 529 (32.5%) potential STOPP criteria situations, with a positive identification of a STOPP PIM in 397 instances (75.0%). Conclusions Although STOPP/START criteria can be considered a high-level tool to identify PIMs, their use may be compromised in scenarios where access to patients’ clinical information is limited.

Keywords

Aged Clinical patient information Drug safety Inappropriate prescribing STOPP/START criteria 

Notes

Funding

Marta Lavrador obtained a complete Doctoral grant from the FCT—Fundação para a Ciência e a Tecnologia (SFRH/BD/123678/2016). No other external funding was received for this study.

Conflicts of interest

The authors declare that they have no conflict of interest.

Supplementary material

11096_2019_920_MOESM1_ESM.docx (19 kb)
Supplementary material 1 (DOCX 20 kb)

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Pharmacology and Pharmaceutical Care Laboratory, Faculty of PharmacyUniversity of Coimbra, Azinhaga de Santa CombaCoimbraPortugal
  2. 2.Coimbra Institute for Clinical and Biomedical Research (iCBR)CoimbraPortugal
  3. 3.Faculty of MedicineUniversity of CoimbraCoimbraPortugal
  4. 4.Department of Social Pharmacy, Faculty of PharmacyUniversity of LisbonLisbonPortugal
  5. 5.Institute for Medicines Research (iMed.ULisboa), University of LisbonLisbonPortugal

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