Application of STOPP/START Criteria for Screening Inappropriate Medication Using in Elderly Patients with Chronic Diseases
Keywords:
ที่คำสั่งใช้ยาที่ไม่เหมาะสม; ผู้สูงอายุ; STOPP/STATRT criteria; โรคเรื้อรัง, Potentially inappropriate medications; Elderly; STOPP/START criteria; Chronic diseaseAbstract
Background and Objectives: Elderly patients with chronic diseases often use many medications, can cause drug related problem. If medication orders are reviewed by effective tool therefore it could reduce drug related problems. The aims of this study were to explore the potentially inappropriate medications (PIM) by using a screening tool of older people's prescriptions (STOPP) and screening tool to alert to right treatment (START) version 2. and the result of medication orders change after pharmacists consult physicians.
Methods: This was a pre-experimental study. We developed tools for screening PIM from STOPP/START criteria. Data were collected in elderly patients with chronic diseases who aged ≥ 65 years with high blood pressure, diabetes or chronic kidney diseases at Latbualuang hospital from 1 November 2017 to 1 February 2018. When pharmacists find an inappropriate medication orders, will consult physicians and collect the effect after that.
Results: We developed a screening tool adapted from STOPP 25 items and START 7 items. There were 1,181 patients participated in the study. STOPP criteria can detect PIM in 53 patients (4.49%) and 122 patients (10.33%) by START criteria and then pharmacists consult physicians to change the medication order. Physicians accept to change the order in 31 patients (72.09%) identified by STOPP criteria and accepted in 82 patients (73.87%) identified by START criteria. Physicians did not change orders but revise order in 9 patients (20.93%) by STOPP criteria and 8 patients (7.21%) by START criteria and physician did not change order in 3 patients (6.98%) by STOPP criteria and 21 patients (18.92%) by START criteria.
Conclusion: This tool adapted from STOPP/START criteria can screen for PIM. Almost physicians changed orders according to pharmacist’s suggestion.
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