School of Pharmacy, Queen's University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK.
Age Ageing. 2013 Jan;42(1):116-20. doi: 10.1093/ageing/afs068. Epub 2012 Jul 24.
STOPP/START was formulated to identify potentially inappropriate prescribing (PIP) and potential prescribing omissions (PPOs) in older people. The purpose of this study was to determine the prevalence of PIP and PPO in older Irish patients in residential care using STOPP/START.
data were collected prospectively from seven publicly funded nursing homes within the Munster Region of Ireland over 3 weeks. Data recorded included: current medication, current medical conditions, previous medical conditions, biochemistry, sex and age. STOPP/START was applied to each patient record.
of the 313 patients recruited, 74.4% (233) were female, mean age (± SD) 84.4 (± 7.5) years. The total number of medicines prescribed was 2,555 [range: 1-16; median: 8 (IQR 6-10 )]. STOPP identified 329 instances of PIP in 187 (59.8%) patients and START identified 199 PPOs in 132 (42.2%) patients. The number of medicines prescribed was positively associated with PIP identified by STOPP (rs = 0.303, P < 0.01). Age, sex and the number of medicines prescribed were not associated with prescribing omissions using START.
a high proportion of patients recruited were prescribed at least one potentially inappropriate medicine, or had an omission of a clinically indicated medicine. Incorporating these tools into every-day practice could play a pivotal role in improving prescribing in this cohort.
STOPP/START 旨在识别老年人中潜在的不适当处方（PIP）和潜在的处方遗漏（PPO）。本研究的目的是使用 STOPP/START 确定爱尔兰居住在养老院的老年人中 PIP 和 PPO 的发生率。
在爱尔兰芒斯特地区的七家公立养老院中，前瞻性地收集了 3 周的数据。记录的数据包括：当前用药、当前疾病、既往疾病、生物化学、性别和年龄。STOPP/START 应用于每个患者记录。
在招募的 313 名患者中，74.4%（233 名）为女性，平均年龄（±标准差）为 84.4（±7.5）岁。开具的药物总数为 2555 种[范围：1-16；中位数：8（IQR 6-10）]。STOPP 在 187 名（59.8%）患者中发现了 329 例 PIP，而 START 在 132 名（42.2%）患者中发现了 199 例 PPO。开具的药物数量与 STOPP 确定的 PIP 呈正相关（rs=0.303，P<0.01）。年龄、性别和开具的药物数量与使用 START 发生的处方遗漏无关。
招募的患者中有很大一部分患者至少被开了一种潜在不适当的药物，或者遗漏了一种临床需要的药物。将这些工具纳入日常实践中可以在改善这一人群的处方方面发挥关键作用。
