Prevention of Potentially Inappropriate Prescribing in Late Life Using Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatment (START) Criteria

Cork University Hospital400 enrolled

Overview

Potentially inappropriate prescribing is common in older patients and encompasses overuse, misuse and underuse of medications. Potentially inappropriate prescribing is associated with negative outcomes including adverse drug events and hospitalization. STOPP (Screening Tool of Older Person's potentially inappropriate Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) is a new screening tool designed to detect instances of potentially inappropriate medication use and under-prescribing of clinically indicated medications in older patients. The purpose of this study is to determine whether clinical implementation of STOPP/START criteria in hospitalized older patients is effective in improving prescribing quality.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Masking

NONE

Enrollment

400

Conditions

Healthy

Interventions

STOPP/START criteria

Eligibility

Sex: ALLMin age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * All patients aged 65 years and older admitted to the general medical services of Cork University Hospital, Cork, Ireland Exclusion Criteria: * Patient admitted to a geriatric medicine service, psychiatry of old age service or clinical pharmacology service, or under review of these services during the previous 12 months * Critically ill patient (admitted to the intensive care unit) * Terminally ill patient * Refusal of patient or hospital physician to participate * No time for the research physician to enrol the patient within 3 days of admission

Outcomes

Primary Outcomes

Appropriateness of prescribing using the Medication Appropriateness Index and the Assessment of Underutilization of Medication Tool

Time frame: Measured on admission, discharge and at 2, 4 and 6 months post-discharge

Secondary Outcomes

Composite health resource utilization including hospital readmission and primary care consultations

Time frame: at 2, 4 and 6 months post-discharge