Dominique A de Groot1, Marloes de Vries1, Karlijn J Joling1, Jos P C M van Campen2, Jacqueline G Hugtenburg3, Rob J van Marum4, Annemieke M A Vermeulen Windsant-van den Tweel5, Petra J M Elders6, Hein P van Hout1. 1. Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands. 2. Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, the Netherlands. 3. Department of Clinical Pharmacology and Pharmacy, VU University Medical Center Amsterdam, Amsterdam, the Netherlands. 4. Department of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam, the Netherlands Department of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands. 5. ZANOB, 's- Hertogenbosch, the Netherlands. 6. Department of General Practice, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
Abstract
BACKGROUND: the STOPP/START criteria are a promising framework to increase appropriate prescribing in the elderly in clinical practice. However, the current definitions of the STOPP/START criteria are rather non-specific, allowing undesirable variations in interpretation and thus application. The aim of this study was to design specifications of the STOPP/START criteria into international disease and medication codes to facilitate computerised extraction from medical records and databases. METHODS: a three round consensus procedure with a multidisciplinary expert panel was organised to prepare, judge and agree on the design of the STOPP/START criteria specifications in corresponding international disease codes (ICD9 and ICPC) and medication codes (ATC). RESULTS: after two rounds consensus was reached for 74% of the STOPP criteria and for 73% of the START criteria. After three rounds full consensus was reached resulting in a specification of 61 out of 62 STOPP criteria and 26 START criteria with their corresponding codes. One criterion could not be specified and for some criteria corresponding disease codes were lacking or imperfect. CONCLUSION: this study showed the necessity of a consensus procedure as even experts frequently differed on how to specify the STOPP/START criteria. This specification enables next steps such as prognostic validation of these criteria on adverse outcomes and studying the impact of improving appropriate prescribing in the elderly.
BACKGROUND: the STOPP/START criteria are a promising framework to increase appropriate prescribing in the elderly in clinical practice. However, the current definitions of the STOPP/START criteria are rather non-specific, allowing undesirable variations in interpretation and thus application. The aim of this study was to design specifications of the STOPP/START criteria into international disease and medication codes to facilitate computerised extraction from medical records and databases. METHODS: a three round consensus procedure with a multidisciplinary expert panel was organised to prepare, judge and agree on the design of the STOPP/START criteria specifications in corresponding international disease codes (ICD9 and ICPC) and medication codes (ATC). RESULTS: after two rounds consensus was reached for 74% of the STOPP criteria and for 73% of the START criteria. After three rounds full consensus was reached resulting in a specification of 61 out of 62 STOPP criteria and 26 START criteria with their corresponding codes. One criterion could not be specified and for some criteria corresponding disease codes were lacking or imperfect. CONCLUSION: this study showed the necessity of a consensus procedure as even experts frequently differed on how to specify the STOPP/START criteria. This specification enables next steps such as prognostic validation of these criteria on adverse outcomes and studying the impact of improving appropriate prescribing in the elderly.
Authors: Michiel C Meulendijk; Marco R Spruit; A Clara Drenth-van Maanen; Mattijs E Numans; Sjaak Brinkkemper; Paul A F Jansen; Wilma Knol Journal: Drugs Aging Date: 2015-06 Impact factor: 3.923
Authors: Bruce Guthrie; Kimberley Kavanagh; Chris Robertson; Karen Barnett; Shaun Treweek; Dennis Petrie; Lewis Ritchie; Marion Bennie Journal: BMJ Date: 2016-08-18