E-ISSN 2231-3206 | ISSN 2320-4672
 

Original Research 


Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital

Maulik M Patel, Andrew S Mark, Nehal A Shah.

Abstract
Background: Inappropriate prescribing is more prevalent in geriatric patients. A popular tool for screening appropriateness of prescribing is the screening tool of older person’s prescriptions (STOPP) and screening tool to alert doctors to right treatment (START) criteria. In this study, our aim was to estimate the incidence of potentially inappropriate prescribing (PIP) utilizing these criteria among patients attending outpatient departments. In addition, we aimed to identify potential factors that are associated with PIP.

Aims and Objectives: The objectives of the study are as follows: (1) To estimate incidence of potentially inappropriate medications (PIMs) using STOPP criteria; (2) To estimate incidence of potential prescribing omissions (PPOs) using START criteria; and (3) To identify potential factors that are associated with PIP.

Materials and Methods: A prospective and cross-sectional study that was observational in nature was performed in patients with age 65 years and above. Prescriptions of these patients were analyzed by collecting relevant data that were subsequently entered in specially designed case record forms. The modified version 2.0 of STOPP/START criteria was utilized to assess PIP in the form of PIMs and PPOs. Data were entered in Microsoft Excel 2013 and analyzed. Categorical variables were described as frequency and percentage whereas continuous variables were described as mean with standard deviation.

Results: Prescriptions of a total 306 patients were evaluated (mean age: 69.4, 60% male, average number of medications per prescription: 5.04 ± 2.44), PIMs were detected in 88 (28.75%) and PPOs in 30 (9.8%) patients. Ninety-six patients had either a PIM or a PPO. PIMs mainly involved were duplication of drug class (26.5%), use of first generation antihistaminic for >1 week (20.4%) and use of glimepiride (18.6%). Major PPOs identified were non-use of angiotensin converting enzyme inhibitors following acute myocardial infarction (26%), non-use of statin therapy (26%), and antiplatelet therapy (21.7%) in patients with diabetes mellitus along with cardiovascular risk factor. Polypharmacy (OR 6.011, P < 0.0001) and comorbidity (OR 3.097, P = 0.015) significantly increase the risk of PIM encounter.

Conclusion: PIP in the form of PIMs and PPOs was prevalent in the studied patients. Polypharmacy and comorbidity were associated with an increased likelihood of PIM.

Key words: Screening Tool of Older Person’s Prescriptions and Screening Tool to Alert Doctors to Right Treatment Criteria; Inappropriate Prescribing; Potentially Inappropriate Medications; Geriatric


 
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How to Cite this Article
Pubmed Style

Patel MM, Mark AS, Shah NA. Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. Natl J Physiol Pharm Pharmacol. 2022; 12(10): 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022


Web Style

Patel MM, Mark AS, Shah NA. Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. https://www.njppp.com/?mno=35499 [Access: December 03, 2022]. doi:10.5455/njppp.2023.13.05208202221052022


AMA (American Medical Association) Style

Patel MM, Mark AS, Shah NA. Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. Natl J Physiol Pharm Pharmacol. 2022; 12(10): 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022



Vancouver/ICMJE Style

Patel MM, Mark AS, Shah NA. Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. Natl J Physiol Pharm Pharmacol. (2022), [cited December 03, 2022]; 12(10): 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022



Harvard Style

Patel, M. M., Mark, . A. S. & Shah, . N. A. (2022) Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. Natl J Physiol Pharm Pharmacol, 12 (10), 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022



Turabian Style

Patel, Maulik M, Andrew S Mark, and Nehal A Shah. 2022. Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. National Journal of Physiology, Pharmacy and Pharmacology, 12 (10), 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022



Chicago Style

Patel, Maulik M, Andrew S Mark, and Nehal A Shah. "Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital." National Journal of Physiology, Pharmacy and Pharmacology 12 (2022), 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022



MLA (The Modern Language Association) Style

Patel, Maulik M, Andrew S Mark, and Nehal A Shah. "Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital." National Journal of Physiology, Pharmacy and Pharmacology 12.10 (2022), 1746-1750. Print. doi:10.5455/njppp.2023.13.05208202221052022



APA (American Psychological Association) Style

Patel, M. M., Mark, . A. S. & Shah, . N. A. (2022) Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital. National Journal of Physiology, Pharmacy and Pharmacology, 12 (10), 1746-1750. doi:10.5455/njppp.2023.13.05208202221052022