Retrospective Study to Describe and Compare the Application of Select Sections of the STOPP/START and Beers Criteria in Medication Reviews in a Musculoskeletal Specialty Practice

Abstract

Problem: Selecting appropriate medications for the aging population is challenging considering the number of chronic illnesses, prescriptions, and healthcare providers involved in their care, not to mention age related changes that impact pharmacokinetics. Significance: Inappropriate medications in geriatric patients can lead to adverse drug reactions (ADR). Medication review tools can assist in the identification of potentially inappropriate medications (PIM) to avoid or closely monitor and prevent ADRs. Purpose: Describe and compare the application of select sections of the STOPP (Screening Tool of Older Persons Prescriptions) /START (Screening Tool to Alert to Right Treatment) and Beers Criteria in a geriatric population. Specific aims include describing and comparing: 1) the rate of PIM identified by sections of the Beers and STOPP Criteria, 2) the rate of potential prescription omissions (PPO) identified by a section of the START Criteria, 3) the most common PIM or PPO drug classes identified, 4) those with polypharmacy (>5 medications), and 5) the time for criteria application. Design: Retrospective descriptive, comparative chart review. Results: A total of 468 medications were prescribed, an average of 7.43 per patient, with 73.02% of patients with polypharmacy. Beers Criteria identified 32 PIM in 39.7% while STOPP Criteria identified 67 PIM in 58.7%. There was a high statistical difference between the number of PIM identified by the STOPP Criteria compared to the Beers Criteria (P=0.01). A total of 16 PPO were identified with START Criteria in 17.5%.