Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, The Netherlands.
Department of Medicine for Older People, Amsterdam University Medical Center, Amsterdam, The Netherlands.
J Am Med Dir Assoc. 2024 Sep;25(9):105143. doi: 10.1016/j.jamda.2024.105143. Epub 2024 Jul 9.
To adapt the 2015 Screening Tool of Older Persons' Prescriptions (STOPP)/Screening Tool to Alert to Right Treatment (START) criteria to older nursing home patients with a limited life expectancy of 1.5 to 2 years.
A modified Delphi consensus study.
The study was established in The Netherlands and conducted online. The international panel consisted of 23 experts with experience in medicine for older people.
The expert panel was presented with the 2015 STOPP/START criteria using an online survey program (Survey Monkey). The panelists were asked for their opinion on the appropriateness of the STOPP and START criteria, and adaptations to these criteria for older nursing home patients with a limited life expectancy on 4-point Likert scales. Consensus was defined as ≥70% of the panelists answering (very) inappropriate or (very) appropriate, and (completely) disagree or (completely) agree.
Twenty-one panelists completed all 3 Delphi rounds. The final list of "Represcribing for Nursing home residents With A Limited life expectancy (ReNeWAL)" criteria comprises 132 criteria: 98 criteria to stop (70 original STOPP criteria and 28 adapted) and 34 criteria to start (16 original START criteria and 18 adapted) for older nursing home patients with a limited life expectancy. Considerations that panelists mentioned for adapting criteria were mainly prevention and treatment of discomfort.
It is clear that represcribing for older nursing home patients is highly complex and requires the consideration of various elements. The ReNeWAL criteria may be useful in enhancing represcribing for older nursing home patients with a limited life expectancy.
将 2015 年老年人处方筛选工具（STOPP）/筛选工具以警示正确治疗（START）标准适用于预期寿命为 1.5 至 2 年的老年疗养院患者。
改良德尔菲共识研究。
该研究在荷兰进行，通过在线方式进行。国际专家组由 23 名具有老年人医学经验的专家组成。
专家组通过在线调查程序（Survey Monkey）了解 2015 年 STOPP/START 标准。专家组成员被要求对 STOPP 和 START 标准的适宜性进行评估，并对这些标准进行评估，以适应预期寿命有限的老年疗养院患者，评估结果采用 4 点李克特量表。共识定义为≥70%的小组成员回答（非常）不合适或（非常）合适，（完全）不同意或（完全）同意。
21 名小组成员完成了全部 3 轮 Delphi 研究。最终的“重新处方给预期寿命有限的疗养院居民（ReNeWAL）”标准列表包含 132 项标准：98 项停止（70 项原始 STOPP 标准和 28 项改编）和 34 项开始（16 项原始 START 标准和 18 项改编），适用于预期寿命有限的老年疗养院患者。小组成员在改编标准时提到的考虑因素主要是预防和治疗不适。
很明显，为老年疗养院患者重新处方是非常复杂的，需要考虑各种因素。ReNeWAL 标准可能有助于提高预期寿命有限的老年疗养院患者的重新处方率。
