CHU Grenoble Alpes, Pôle Pharmacie, F-38000 Grenoble, France.
CHU Grenoble Alpes, Pôle Pluridisciplinaire de Médecine et de Gérontologie Clinique, F-38000 Grenoble, France.
Arch Gerontol Geriatr. 2018 Mar-Apr;75:16-19. doi: 10.1016/j.archger.2017.10.022. Epub 2017 Nov 4.
STOPP (Screening Tool of Older Person's Prescriptions) criteria have been used in acute care and nursing home settings as a screening tool to assess Potentially Inappropriate Medication (PIM) for elderly people. Furthermore, this tool could help General Practitioners (GPs) to lower PIM frequency in primary care.
The aim of the study was to measure the impact of STOPP criteria applied by the GP on prescriptions during a primary care consultation.
SETTING, SUBJECTS AND METHOD: Twenty GPs were involved and trained to use STOPP criteria. GPs were asked to use STOPP criteria for elderly patients (>75years old) who were taking at least five different drugs, seen over a two-month period. The rate of PIM according to STOPP criteria was measured before and after training. Prescription quality was compared using the Medication Appropriateness Index (MAI) score.
Overall, 172 prescriptions were analyzed. A total of 170 PIM were identified according to STOPP criteria before the intervention. Fifty-seven percent of the population (n=98 patients) had at least one PIM. GP's intervention decreased the number of PIM according to STOPP criteria to 106 and was beneficial for 44.9% of the patients (n=44). The mean MAI score of all medications and PIM decreased by 14.3% (p<0.001) and 39.1% (p<0.001) respectively.
Application of STOPP criteria by GPs is an effective tool to decrease PIM and MAI score in primary care. The generalization of the use of STOPP criteria during GP consultation should be fostered.
STOPP（老年人处方筛选工具）标准已在急症护理和养老院环境中用作筛选工具，以评估老年人的潜在不适当药物（PIM）。此外，该工具可以帮助全科医生（GP）降低初级保健中的 PIM 频率。
本研究旨在衡量 GP 应用 STOPP 标准对初级保健咨询期间处方的影响。
设置、受试者和方法：20 名 GP 参与并接受 STOPP 标准培训。要求 GP 为服用至少五种不同药物的>75 岁老年患者使用 STOPP 标准，为期两个月。在培训前后测量根据 STOPP 标准的 PIM 发生率。使用药物适宜性指数（MAI）评分比较处方质量。
总体而言，分析了 172 份处方。在干预前，根据 STOPP 标准共确定了 170 种 PIM。57%的人群（n=98 名患者）至少有一种 PIM。GP 的干预将根据 STOPP 标准确定的 PIM 数量减少到 106 种，对 44.9%的患者（n=44）有益。所有药物和 PIM 的平均 MAI 评分分别降低了 14.3%（p<0.001）和 39.1%（p<0.001）。
GP 应用 STOPP 标准是降低初级保健中 PIM 和 MAI 评分的有效工具。应促进 GP 咨询期间 STOPP 标准的广泛应用。
