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

Study Overview
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Brief Summary
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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.

Official Title
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Prevention of Potentially Inappropriate Prescribing in Late Life Using STOPP (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions) and START (Screening Tool to Alert Doctors to Right i.e. Appropriate Indicated Treatment): A Randomized Controlled Trial.

Conditions
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Healthy

Intervention / Treatment
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* Other: STOPP/START criteria


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: STOPP/START intervention<br>STOPP/START intervention group | Other: STOPP/START criteria<br>* Application of STOPP/START criteria to the patient's prescription and diagnostic information with subsequent written recommendation on pharmaceutical care to the patient's medical team<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Appropriateness of prescribing using the Medication Appropriateness Index and the Assessment of Underutilization of Medication Tool |  | Measured on admission, discharge and at 2, 4 and 6 months post-discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite health resource utilization including hospital readmission and primary care consultations |  | at 2, 4 and 6 months post-discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Drug therapy, Prescribing, Appropriateness, Randomized controlled trial, STOPP/START criteria, Appropriateness of prescribing in older patients, Prescription Drugs