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    Application of STOPP and START criteria: interrater reliability among pharmacists.

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    Authors
    Ryan, Cristin
    O'Mahony, Denis
    Byrne, Stephen
    Affiliation
    School of Pharmacy, University College Cork, Cork, Republic of Ireland. cristin.ryan@ucc.ie
    Issue Date
    2009-07
    MeSH
    Aged
    Community Pharmacy Services
    Drug Interactions
    Drug Utilization Review
    Female
    Humans
    Male
    Medication Errors
    Observer Variation
    Pharmacists
    Pharmacy Service, Hospital
    Physician's Practice Patterns
    Prescription Drugs
    Reproducibility of Results
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    Citation
    Application of STOPP and START criteria: interrater reliability among pharmacists. 2009, 43 (7):1239-44 Ann Pharmacother
    Journal
    The Annals of pharmacotherapy
    URI
    http://hdl.handle.net/10147/200997
    DOI
    10.1345/aph.1M157
    PubMed ID
    19584381
    Abstract
    Inappropriate prescribing is a well-documented problem in older people. The new screening tools, STOPP (Screening Tool of Older Peoples' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) have been formulated to identify potentially inappropriate medications (PIMs) and potential errors of omissions (PEOs) in older patients. Consistent, reliable application of STOPP and START is essential for the screening tools to be used effectively by pharmacists.
    To determine the interrater reliability among a group of clinical pharmacists in applying the STOPP and START criteria to elderly patients' records.
    Ten pharmacists (5 hospital pharmacists, 5 community pharmacists) were given 20 patient profiles containing details including the patients' age and sex, current medications, current diagnoses, relevant medical histories, biochemical data, and estimated glomerular filtration rate. Each pharmacist applied the STOPP and START criteria to each patient record. The PIMs and PEOs identified by each pharmacist were compared with those of 2 academic pharmacists who were highly familiar with the application of STOPP and START. An interrater reliability analysis using the kappa statistic (chance corrected measure of agreement) was performed to determine consistency between pharmacists.
    The median kappa coefficients for hospital pharmacists and community pharmacists compared with the academic pharmacists for STOPP were 0.89 and 0.88, respectively, while those for START were 0.91 and 0.90, respectively.
    Interrater reliability of STOPP and START tools between pharmacists working in different sectors is good. Pharmacists working in both hospitals and in the community can use STOPP and START reliably during their everyday practice to identify PIMs and PEOs in older patients.
    Item Type
    Article
    Language
    en
    ISSN
    1542-6270
    ae974a485f413a2113503eed53cd6c53
    10.1345/aph.1M157
    Scopus Count
    Collections
    Cork University Hospital

    entitlement

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