Beers criteria and STOPP/START criteria: medication evaluation with screening tools in elderly outpatients

Objectives:

Medication adverse effects can have profound medical and safety consequences for elderly patients. Strategies to identify both potentially inappropriate and appropriate medications have been developed. Tools utilized to identify potentially inappropriate medication are the Beers criteria and the Screening Tool of Older Person’s Prescriptions (STOPP) criteria. Additionally, the Screening Tool to Alert doctors to Right Treatment (START) criteria is utilized to determine potentially appropriate medications in the elderly. Limited data is available comparing the Beers criteria and STOPP criteria, with most data coming primarily from the inpatient population. Additional data is needed to determine which criteria would be most suitable in an outpatient setting. The primary outcome of this study is to determine the most appropriate screening tool in the ambulatory setting for evaluating medication use in an ambulatory geriatric population comparing the Beers and STOPP criteria.

Methods:

This institutional review board approved retrospective chart review will include patients referred for geriatric assessments at the St. Vincent Center for Healthy Aging during the months of January 2011 through February 2012. Exclusion criteria include patients who present with no medications, patients in whom a medication list is unable to be obtained, follow-up appointments, or patients age less than 65 years. Each patient’s medication list and medical history will be screened using the three tools described above (Beers criteria, START/STOPP criteria). Recommendations based on Beers criteria and STOPP criteria will be compared in regards to the number of potentially inappropriate medications, prescription cost savings, pill burden, and Anticholinergic Drug Scale scores. These factors will be modeled using multiple regressions and the adjusted means produced will be used to compare the criteria.

Results:

Data collection is ongoing.

Conclusions:

Results and conclusions will be presented at the 2012 ACCP Virtual Poster Symposium.