Healthy
Conditions
Keywords
Drug therapy, Prescribing, Appropriateness, Randomized controlled trial, STOPP/START criteria, Appropriateness of prescribing in older patients, Prescription Drugs
Brief summary
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.
Interventions
OTHERSTOPP/START criteria
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
Sponsors
Cork University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | 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
| Measure | Time frame |
|---|---|
| Composite health resource utilization including hospital readmission and primary care consultations | at 2, 4 and 6 months post-discharge |
Countries
Ireland
Outcome results
None listed