Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.
Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Centre, Quebec, Quebec, Canada.
Drug Saf. 2024 Nov;47(11):1061-1074. doi: 10.1007/s40264-024-01453-1. Epub 2024 Jul 11.
The growing complexity of geriatric pharmacotherapy necessitates effective tools for mitigating the risks associated with polypharmacy. The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) criteria have been instrumental in optimizing medication management among older adults. Despite their large adoption for improving the reduction of potentially inappropriate medications (PIM) and patient outcomes, the implementation of STOPP/START criteria faces notable challenges. The extensive number of criteria in the latest version and time constraints in primary care pose practical difficulties, particularly in settings with a high number of older patients. This paper critically evaluates the challenges and evolving implications of applying the third version of the STOPP/START criteria across various clinical settings, focusing on the European healthcare context. Utilizing a "Questions & Answers" format, it examines the criteria's implementation and discusses relevant suitability and potential adaptations to address the diverse needs of different clinical environments. By emphasizing these aspects, this paper aims to contribute to the ongoing discourse on enhancing medication safety and efficacy in the geriatric population, and to promote more person-centred care in an aging society.
老年病药物治疗的日益复杂性需要有效的工具来降低多种药物治疗相关的风险。老年人潜在不适当处方筛选工具（STOPP）/识别需要停止的药物（START）标准在优化老年人的药物管理方面发挥了重要作用。尽管它们被广泛采用以改善潜在不适当药物（PIM）的减少和患者的治疗结果，但 STOPP/START 标准的实施面临着显著的挑战。最新版本中标准数量众多，以及初级保健中的时间限制，在老年患者数量较多的环境中带来了实际困难。本文批判性地评估了在不同临床环境中应用第三版 STOPP/START 标准的挑战和不断变化的影响，重点关注欧洲医疗保健背景。本文采用“问答”格式，检查了标准的实施，并讨论了相关的适用性和潜在的适应性，以满足不同临床环境的多样化需求。通过强调这些方面，本文旨在为提高老年人群药物安全性和疗效的持续讨论做出贡献，并在老龄化社会中促进更以患者为中心的护理。
