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European geriatric medicine
Aug, 2024;15 (4): 1149-1158.

Applicability of STOPP/START prescribing criteria in integrated Swedish administrative health registries and a Swedish population-based cohort.

Cheima Amrouch, Souad Amrouch, Lu Dai, Amaia Calderón-Larrañaga, Jonas W Wastesson, Kristina Johnell, Davide Liborio Vetrano, Delphine De Smedt, Mirko Petrovic
Author Information
  1. Cheima Amrouch: Department of Public Health and Primary Care, Ghent University, Ghent, Belgium. cheima.amrouch@ugent.be. ORCID
  2. Souad Amrouch: Department of Medicine, Antwerp University, Antwerp, Belgium.
  3. Lu Dai: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
  4. Amaia Calderón-Larrañaga: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
  5. Jonas W Wastesson: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
  6. Kristina Johnell: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
  7. Davide Liborio Vetrano: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
  8. Delphine De Smedt: Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
  9. Mirko Petrovic: Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
PMID: 38753270 DOI: 10.1007/s41999-024-00990-3

Abstract

PURPOSE: The STOPP/START criteria are frequently applied in observational studies to assess potentially inappropriate prescribing in older adults. This study aimed to assess the applicability of the three available STOPP/START versions in two distinct data sources.
METHODS: To evaluate the applicability of the three versions of STOPP/START criteria, we used two observational data sources: (i) Integrated Swedish administrative health registries (ISHR) encompassing routinely collected health data and (ii) the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K), based on health professional-led clinical assessments. The Anatomical Therapeutic Classification code (ATC) was used to categorise medications. Diseases were categorised using the international classification of diseases version 10 (ICD10).
RESULTS: The first STOPP/START version demonstrated an applicability rate of 80% in ISHR and 84% in SNAC-K. The second version demonstrated an applicability of 64% in ISHR and 74% in SNAC-K. The third version showed an applicability of 66% in ISHR and 77% in SNAC-K. Challenges in applicability included broad definitions, vague terminology, and the lack of information on disease severity, symptomatic traits, and stability of certain conditions.
CONCLUSION: The applicability of the STOPP/START criteria in observational studies seems to have decreased in more recent versions of the tool. Population-based studies with comprehensive clinical assessments may offer higher applicability compared to studies based on administrative data. Future versions of the STOPP/START criteria should prioritise clear and unambiguous definitions to improve their applicability in research and promote result generalisability and comparability.

Keywords

Applicability of STOPP/START Automation of STOPP/START Medication review STOPP/START Screening tool

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MeSH Term

Humans
Sweden
Registries
Aged
Female
Male
Inappropriate Prescribing
Aged, 80 and over
Potentially Inappropriate Medication List
Cohort Studies
Journal Article Observational Study

Word Cloud

Created with Highcharts 10.0.0STOPP/STARTapplicabilitycriteriastudiesversionsdataSwedishhealthISHRSNAC-Kversionobservationaladministrativeassessprescribingstudythreetwousedregistriespopulation-basedbasedclinicalassessmentsdemonstrateddefinitionstoolApplicabilityPURPOSE:frequentlyappliedpotentiallyinappropriateolderadultsaimedavailabledistinctsourcesMETHODS:evaluatesources:IntegratedencompassingroutinelycollectediiNationalAgingCareKungsholmenprofessional-ledAnatomicalTherapeuticClassificationcodeATCcategorisemedicationsDiseasescategorisedusinginternationalclassificationdiseases10ICD10RESULTS:firstrate80%84%second64%74%thirdshowed66%77%ChallengesincludedbroadvagueterminologylackinformationdiseaseseveritysymptomatictraitsstabilitycertainconditionsCONCLUSION:seemsdecreasedrecentPopulation-basedcomprehensivemayofferhighercomparedFutureprioritiseclearunambiguousimproveresearchpromoteresultgeneralisabilitycomparabilityintegratedcohortAutomationMedicationreviewScreening

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