STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation.

Hdl Handle:
http://hdl.handle.net/10147/209219
Title:
STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation.
Authors:
Gallagher, P; Ryan, C; Byrne, S; Kennedy, J; O'Mahony, D
Affiliation:
Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork,, Ireland.
Citation:
Int J Clin Pharmacol Ther. 2008 Feb;46(2):72-83.
Journal:
International journal of clinical pharmacology and therapeutics
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209219
PubMed ID:
18218287
Abstract:
OBJECTIVE: Older people experience more concurrent illnesses, are prescribed more medications and suffer more adverse drug events than younger people. Many drugs predispose older people to adverse events such as falls and cognitive impairment, thus increasing morbidity and health resource utilization. At the same time, older people are often denied potentially beneficial, clinically indicated medications without a valid reason. We aimed to validate a new screening tool of older persons' prescriptions incorporating criteria for potentially inappropriate drugs called STOPP (Screening Tool of Older Persons' Prescriptions) and criteria for potentially appropriate, indicated drugs called START (Screening Tool to Alert doctors to Right, i.e. appropriate, indicated Treatment). METHODS: A Delphi consensus technique was used to establish the content validity of STOPP/START. An 18-member expert panel from academic centers in Ireland and the United Kingdom completed two rounds of the Delphi process by mail survey. Inter-rater reliability was assessed by determining the kappa-statistic for measure of agreement on 100 data-sets. RESULTS: STOPP is comprised of 65 clinically significant criteria for potentially inappropriate prescribing in older people. Each criterion is accompanied by a concise explanation as to why the prescribing practice is potentially inappropriate. START consists of 22 evidence-based prescribing indicators for commonly encountered diseases in older people. Inter-rater reliability is favorable with a kappa-coefficient of 0.75 for STOPP and 0.68 for START. CONCLUSION: STOPP/START is a valid, reliable and comprehensive screening tool that enables the prescribing physician to appraise an older patient's prescription drugs in the context of his/her concurrent diagnoses.
Language:
eng
MeSH:
Abbreviations as Topic; Age Factors; Aged; Analgesics/therapeutic use; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use; Aspirin/therapeutic use; Bendroflumethiazide/therapeutic use; Delphi Technique; Digoxin/therapeutic use/toxicity; Diuretics/therapeutic use; Drug Prescriptions/classification/*statistics & numerical data; Drug Therapy/adverse effects/standards/statistics & numerical data; Drug Utilization Review/*methods/statistics & numerical data; Glomerular Filtration Rate/drug effects; Great Britain; Health Services for the Aged/organization & administration/*statistics &; numerical data; Humans; Ireland; Metformin/therapeutic use; Physician's Practice Patterns/*statistics & numerical data; Reproducibility of Results; Risk Factors; Ticlopidine/analogs & derivatives/therapeutic use; Time Factors
ISSN:
0946-1965 (Print); 0946-1965 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorGallagher, Pen_GB
dc.contributor.authorRyan, Cen_GB
dc.contributor.authorByrne, Sen_GB
dc.contributor.authorKennedy, Jen_GB
dc.contributor.authorO'Mahony, Den_GB
dc.date.accessioned2012-02-03T15:15:24Z-
dc.date.available2012-02-03T15:15:24Z-
dc.date.issued2012-02-03T15:15:24Z-
dc.identifier.citationInt J Clin Pharmacol Ther. 2008 Feb;46(2):72-83.en_GB
dc.identifier.issn0946-1965 (Print)en_GB
dc.identifier.issn0946-1965 (Linking)en_GB
dc.identifier.pmid18218287en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209219-
dc.description.abstractOBJECTIVE: Older people experience more concurrent illnesses, are prescribed more medications and suffer more adverse drug events than younger people. Many drugs predispose older people to adverse events such as falls and cognitive impairment, thus increasing morbidity and health resource utilization. At the same time, older people are often denied potentially beneficial, clinically indicated medications without a valid reason. We aimed to validate a new screening tool of older persons' prescriptions incorporating criteria for potentially inappropriate drugs called STOPP (Screening Tool of Older Persons' Prescriptions) and criteria for potentially appropriate, indicated drugs called START (Screening Tool to Alert doctors to Right, i.e. appropriate, indicated Treatment). METHODS: A Delphi consensus technique was used to establish the content validity of STOPP/START. An 18-member expert panel from academic centers in Ireland and the United Kingdom completed two rounds of the Delphi process by mail survey. Inter-rater reliability was assessed by determining the kappa-statistic for measure of agreement on 100 data-sets. RESULTS: STOPP is comprised of 65 clinically significant criteria for potentially inappropriate prescribing in older people. Each criterion is accompanied by a concise explanation as to why the prescribing practice is potentially inappropriate. START consists of 22 evidence-based prescribing indicators for commonly encountered diseases in older people. Inter-rater reliability is favorable with a kappa-coefficient of 0.75 for STOPP and 0.68 for START. CONCLUSION: STOPP/START is a valid, reliable and comprehensive screening tool that enables the prescribing physician to appraise an older patient's prescription drugs in the context of his/her concurrent diagnoses.en_GB
dc.language.isoengen_GB
dc.subject.meshAbbreviations as Topicen_GB
dc.subject.meshAge Factorsen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAnalgesics/therapeutic useen_GB
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal/therapeutic useen_GB
dc.subject.meshAspirin/therapeutic useen_GB
dc.subject.meshBendroflumethiazide/therapeutic useen_GB
dc.subject.meshDelphi Techniqueen_GB
dc.subject.meshDigoxin/therapeutic use/toxicityen_GB
dc.subject.meshDiuretics/therapeutic useen_GB
dc.subject.meshDrug Prescriptions/classification/*statistics & numerical dataen_GB
dc.subject.meshDrug Therapy/adverse effects/standards/statistics & numerical dataen_GB
dc.subject.meshDrug Utilization Review/*methods/statistics & numerical dataen_GB
dc.subject.meshGlomerular Filtration Rate/drug effectsen_GB
dc.subject.meshGreat Britainen_GB
dc.subject.meshHealth Services for the Aged/organization & administration/*statistics &en_GB
dc.subject.meshnumerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMetformin/therapeutic useen_GB
dc.subject.meshPhysician's Practice Patterns/*statistics & numerical dataen_GB
dc.subject.meshReproducibility of Resultsen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshTiclopidine/analogs & derivatives/therapeutic useen_GB
dc.subject.meshTime Factorsen_GB
dc.titleSTOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation.en_GB
dc.contributor.departmentDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork,, Ireland.en_GB
dc.identifier.journalInternational journal of clinical pharmacology and therapeuticsen_GB
dc.description.provinceMunster-

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