Improving usability of the STOPP/START version 3 criteria: development of a practice tool for clinicians, students and researchers.

BACKGROUND

The STOPP/START criteria are aimed to be used by clinicians to perform medication review to optimize pharmacotherapy in older adults. The STOPP/START.version 3 (SS.v3) published in European Geriatric Medicine in 2023 updated and significantly extended the previous version. SS.v3 is more open to criticism for its poor usability in daily clinical practice. The present study aimed at contributing to SS.v3 by highlighting the new content of its criteria and by providing clinicians, students and researchers with a user-friendly presentation to facilitate medication review.

METHODS

The SS.v3 criteria were reviewed by seven geriatricians and clinical pharmacists with expertise in pharmacotherapy in older adults. The 190 SS.v3 criteria were carefully compared to the 115 SS.v2 criteria in order to identify the new ones and those with clinically significant modifications. A single-entry table was developed for the medications (STOPP.v3) and the medical conditions (START.v3).

RESULTS

Among the 133 STOPP.v3 criteria, we identified 54 new (41%) and 25 modified (19%) ones. The 57 START.v3 criteria include 24 new (42%) and 17 modified (30%) ones. The single-entry table is a comprehensive presentation of SSv3 in 3 pages. It is systematically organized and upfront presents the medication for the STOPP criteria and the condition for the START criteria, enhancing its usability.

CONCLUSION

This work highlights many new and modified SS.v3 criteria that clinicians, students and researchers should be aware of. The single-entry table for STOPP medications and START clinical conditions may facilitate medication review for older adults in daily clinical practice.