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Table 2 STOPP criteria applied to TILDA data for all those aged ≥65 years in Ireland in 2010

From: Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish LongituDinal Study on Ageing study (TILDA)

STOPP criteria description Potentially inappropriate prescription (n) Potentially inappropriate prescription (%) Proportionate prescribing per indication (%)a
Cardiovascular system
 Loop diuretic as first line-monotherapy for hypertension (safer, more effective alternatives available) 9 0.26 0.55
 Thiazide diuretic with a history of gout (may exacerbate gout) 3 0.09 3.80
 Beta-blocker with COPD (risk of increased bronchospasm) 31 0.90 18.02
 Beta-blocker with verapamil (risk of symptomatic heart block) 4 0.12 0.52
 Aspirin and warfarin without histamine H2 receptor antagonist (except cimetidine) or proton pump inhibitor (high risk of gastrointestinal bleeding) 13 0.38 1.00
 Dipyridamole as monotherapy for cardiovascular secondary prevention (no evidence of efficacy) 5 0.14 0.20
 Aspirin with a past history of peptic ulcer disease without histamine H2 receptor antagonist or Proton Pump Inhibitor (risk of bleeding) 38 1.10 16.38
 Aspirin with no history of coronary, cerebral, or peripheral vascular symptoms or occlusive event (not indicated) 112 3.24 12.50
Central nervous system and psychotropic drugs
 TCA and glaucoma (exacerbate glaucoma) 3 0.09 2.36
 TCA and opiate or calcium channel blockers (risk of severe constipation) 16 0.46 2.36
 Phenothiazines in patients with epilepsy (may lower seizure threshold) 3 0.09 2.46
 Anticholinergics to treat extra-pyramidal side-effects of neuroleptic medications (risk of anticholinergic toxicity) 3 0.09 6.82
Gastrointestinal system
 Prochlorperazine or metoclopramide with parkinsonism (risk of exacerbating parkinsonism) 1 0.03 3.23
Respiratory system
 Theophylline as monotherapy for COPD (safer, more effective alternative: risk of adverse effects due to narrow therapeutic index) 11 0.32 6.40
 Nebulised ipratropium with glaucoma (exacerbate glaucoma) 0
Musculoskeletal system
 NSAID with history of peptic ulcer disease or gastrointestinal bleeding, unless with concurrent histamine H2 receptor antagonist, PPI or misoprostol (risk of peptic ulcer relapse) 10 0.29 4.31
 NSAID with moderate-severe hypertension (moderate: 160/100–179/109 mmHg; severe: ≥180/110 mmHg) (risk of exacerbation of hypertension) 200 5.79 10.92
 NSAID with heart failure (risk of exacerbation of heart failure) 5 0.14 9.26
 Warfarin and NSAID (risk of gastrointestinal bleeding) 8 0.23 1.57
Urogenital system
 Antimuscarinic drugs with chronic glaucoma (>3 months) (risk of acute exacerbation of glaucoma) b 5 0.15 3.94
 Alpha-blockers in males with frequent incontinence i.e., one or more episodes of incontinence daily (risk of urinary frequency and worsening of incontinence) c 9 0.55 8.18
Endocrine system
 Glibenclamide or chlorpropamide with type 2 diabetes mellitus (risk of prolonged hypoglycemia) 3 0.09 0.82
Drugs that adversely affect those prone to falls (≥ 1 fall in past 3 months)
 Benzodiazepines (sedative, may cause reduced sensorium, impair balance) d 40 1.16 14.55
 Neuroleptic drugs (may cause gait dyspraxia, Parkinsonism) d 6 0.17 2.18
 First generation antihistamines (sedative, may impair sensorium) d 1 0.03 0.36
Duplicate drug class prescription (optimization of monotherapy within a single drug class)
 Two concurrent opiates 3 0.09 2.26
 Two concurrent NSAIDs 21 0.61 5.97
 Two concurrent SSRIs 0
 Two concurrent antidepressants 2 0.06 3.03
 Two concurrent loop diuretics 0
 Two concurrent ACE inhibitors 23 0.67 2.28
  1. COPD chronic obstructive pulmonary disease, TCA tricyclic antidepressant, NSAID non-steroidal anti-inflammatory drug, SSRI selective serotonin reuptake inhibitor, ACE inhibitors angiotensin converting enzyme inhibitors and Angiotensin receptor blockers
  2. aProportionate prescribing per indication, e.g., prevalence of STOPP criteria as a proportion of the overall disease or drug prevalence, e.g.,Beta-blocker with COPD as a proportion of COPD prevalence, two concurrent opiates as a proportion of opiates prevalence
  3. b8 (0.23 %) missing data for chronic glaucoma variable
  4. cProportion of male participants only, 5 (0.30 %) missing data for urinary incontinence variable
  5. d1 (0.03 %) missing data for falls in past year variable