A comparison of the Beers and STOPP criteria for identifying the use of potentially inappropriate medications among elderly patients in primary care.

Abstract

Explicit criteria for evaluating the appropriateness of medication use among the elderly have been extensively employed in several countries. The aim of the current study was to assess and characterize the prevalence of potentially inappropriate medications (PIMs) according to the Screening Tool of Older People's Prescriptions (STOPP) criteria and compare these data with the 2012 Beers criteria. A prospective survey of the medications used by elderly patients was performed. A total of 142 participants were randomly selected via systematic sampling. The Beers and STOPP criteria were applied to evaluate the use of PIMs among the sample. All of the medications included in these criteria were assessed for their availability in Brazil. The prevalence of PIMs was chosen as an occurrence measure and compared among the exposure group using the prevalence ratio (PR) as a measure of association. The prevalence of PIM use in the sample was 33.8% according to the STOPP criteria and 51.8% using the 2012 Beers criteria. The most prevalent PIMs according to the Beers criteria were short-acting nifedipine (17.4%) and glyburide (11.9%); according to the STOPP criteria, they were acetylsalicylic acid (32.9%), clonazepam (10.1%) and diclofenac (6.3%). The use of four or more drugs (polypharmacy) was associated with a higher prevalence of PIM use (PR = 3.11, 95% CIs = 1.65-5.85). The 2012 Beers criteria identified more PIMs than the STOPP criteria. This difference highlights the need to develop national criteria.