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Hospital physicians' and older patients' agreement with individualised STOPP/START-based medication optimisation recommendations in a clinical trial setting.
Huibers, C J A Sallevelt, B T G M Heij, J M J Op O'Mahony, D Rodondi, N Dalleur, O van Marum, R J Egberts, A C G Wilting, I Knol, W
Huibers, C J A
Sallevelt, B T G M
Heij, J M J Op
O'Mahony, D
Rodondi, N
Dalleur, O
van Marum, R J
Egberts, A C G
Wilting, I
Knol, W
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Departments
Date
2022-03-15
Date Submitted
Keywords
multimorbidity
Pharmacotherapy optimisation
Polypharmacy
STOPP/START criteria
Shared-decision-making CDSS
Pharmacotherapy optimisation
Polypharmacy
STOPP/START criteria
Shared-decision-making CDSS
Other Subjects
Subject Mesh
Planned Date
Start Date
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Principal Investigators
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Abstract
139 patients were included, mean (SD) age 78.3 (5.1) years, 47% male and median (IQR) number of medications at admission 11 (9-14). In total, 371 recommendations were discussed with patients and physicians, overall agreement was 61.6% for STOPP and 60.7% for START recommendations. Highest agreement was found for initiation of osteoporosis agents and discontinuation of proton pump inhibitors (both 74%). Factors associated with higher agreement in multivariate analysis were: female gender (+ 17.1% [3.7; 30.4]), ≥ 1 falls in the past year (+ 15.0% [1.5; 28.5]) and renal impairment i.e. eGFR 30-50 ml/min/1.73 m2; (+ 18.0% [2.0; 34.0]). The main reason for disagreement (40%) was patients' reluctance to discontinue or initiate medication.
Language
en
Citation
ISSN
1878-7649
eISSN
ISBN
DOI
10.1007/s41999-022-00633-5
PMID
35291025