Drenth-van Maanen A Clara, Leendertse Anne J, Jansen Paul A F, Knol Wilma, Keijsers Carolina J P W, Meulendijk Michiel C, van Marum Rob J
Department of Geriatrics, University Medical Center Utrecht, Utrecht, The Netherlands.
Expertise Centre Pharmacotherapy for Old Persons (Ephor), Utrecht, The Netherlands.
J Eval Clin Pract. 2018 Apr;24(2):317-322. doi: 10.1111/jep.12787. Epub 2017 Aug 4.
Inappropriate prescribing is a major health care issue, especially regarding older patients on polypharmacy. Multiple implicit and explicit prescribing tools have been developed to improve prescribing, but these have hardly ever been used in combination. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) combines implicit prescribing tools with the explicit Screening Tool to Alert physicians to the Right Treatment and Screening Tool of Older People's potentially inappropriate Prescriptions criteria and has shared decision-making with the patient as a critical step. This article describes the STRIP and its ability to identify potentially inappropriate prescribing. The STRIP improved general practitioners' and final-year medical students' medication review skills. The Web-application STRIP Assistant was developed to enable health care providers to use the STRIP in daily practice and will be incorporated in clinical decision support systems. It is currently being used in the European Optimizing thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly (OPERAM) project, a multicentre randomized controlled trial involving patients aged 75 years and older using multiple medications for multiple medical conditions. In conclusion, the STRIP helps health care providers to systematically identify potentially inappropriate prescriptions and medication-related problems and to change the patient's medication regimen in accordance with the patient's needs and wishes. This article describes the STRIP and the available evidence so far. The OPERAM study is investigating the effect of STRIP use on clinical and economic outcomes.
不恰当的处方是一个重大的医疗保健问题，尤其是对于使用多种药物的老年患者而言。为了改善处方情况，已经开发了多种隐性和显性的处方工具，但这些工具几乎从未被结合使用过。减少不恰当处方系统工具（STRIP）将隐性处方工具与显性的“提醒医生正确治疗筛查工具”以及“老年人潜在不恰当处方标准筛查工具”相结合，并将与患者共同决策作为关键步骤。本文介绍了STRIP及其识别潜在不恰当处方的能力。STRIP提高了全科医生和医学专业最后一年学生的药物审查技能。网络应用程序STRIP助手的开发是为了使医疗保健提供者能够在日常实践中使用STRIP，并将被纳入临床决策支持系统。它目前正在欧洲优化治疗以预防多病老年患者可避免的住院治疗（OPERAM）项目中使用，这是一项多中心随机对照试验，涉及75岁及以上使用多种药物治疗多种疾病的患者。总之，STRIP有助于医疗保健提供者系统地识别潜在不恰当的处方和与药物相关的问题，并根据患者的需求和意愿改变患者的药物治疗方案。本文介绍了STRIP和目前已有的证据。OPERAM研究正在调查使用STRIP对临床和经济结果的影响。
