Evaluación de la actualización de los criterios STOPP-START en atención primaria / Updated report on STOPP-START criteria in Primary Care

Introducción: El objetivo de este trabajo es averiguar la prevalencia de prescripción potencialmente inapropiada (PPI) en población mayor de 64 años en Avilés, Asturias. Material y métodos: Estudio descriptivo transversal multicéntrico en seis centros de salud. Se seleccionó una muestra de 400 personas obtenida por muestreo aleatorio proporcional a la población adscrita a cada centro de salud. Se revisaron las historias clínicas informatizadas y se aplicaron los criterios STOPP-START (versión 2014 con 114 ítems) para evaluar la PPI. Resultados: Se estudiaron 378 (95,5%) pacientes, con una media de edad de 75,4 años (DE: 7,4) y una proporción de 57,7% mujeres. El 94,2% (IC95%:91,7-96,7) presentaban alguna PPI. Atendiendo solo a los criterios STOPP un 52,4% (IC95%:47,2-57,6) de pacientes presentaba al menos un incumplimiento y en los START un 90,5% (IC95%:87,4-93,6) que se reducía a 40,5% (IC95%: 36,4-45,6) si se eliminaban los criterios referidos a vacunaciones. Entre los criterios STOPP, la PPI más frecuente fue la toma de benzodiacepinas seguido del uso de medicamentos sin indicación basada en la evidencia; entre los START fueron la vacunación antineumocócica y la ausencia de la toma de suplementos de vitamina D y calcio en osteoporosis. Conclusiones: Nivel elevado de PPI, muy superior al resultante en la versión previa especialmente para los criterios START. Existe un elevado nivel de PPI en relación con el uso de benzodicepinas y el empleo de medicamentos sin evidencia clínica. Los criterios STOPP-START son útiles en atención primaria para evaluar la PPI

Introduction: The aim of this study is to determine the rate of potentially inappropriate prescriptions (PIP) in people older than 64 years of age in Avilés, Asturias, Spain. Materials and methods: A descriptive cross-sectional study was conducted in six Health Care Centres. A sample of 400 people was selected, obtained by a random sampling proportional to the population registered in each Health Centre. A review was made of the computerised clinical records, and the STOPP-START (version 2014 with 114 items) criteria were applied to evaluate the PIP. Results: The study contained 378 (95.5%) patients with a mean age of 75.4 (SD: 7.4) and of which 57.7% were women. Almost all (94.2%: 95% CI; 91.7-96.7) met some PIP criteria. Taking only the STOPP criteria into consideration, 52.4% (95%CI: 47.2-57.6) met at least one breach, and in the START criteria a 90.5% (95%CI; 87.4-93.6), which was reduced to 40.5% (95%CI; 36.4-45.6) if criteria on vaccination were removed. In the STOPP criteria, the most frequent PIP was taking benzodiazepines followed by the use of medication without indications based on the evidence; in the START, the criteria was the anti-pneumococcus vaccination, and the lack of taking vitamin D supplements and calcium in osteoporosis. Conclusions: There were high levels of PIP, very superior to the previous version, especially for the START criteria. There is a high level of PIP related to the use of benzodiazepines and the use of medication without any clinic evidence. The STOPP-START criteria are useful in Primary Care to assess the PIP

[Updated report on STOPP-START criteria in Primary Care]. / Evaluación de la actualización de los criterios STOPP-START en atención primaria.

INTRODUCTION: The aim of this study is to determine the rate of potentially inappropriate prescriptions (PIP) in people older than 64 years of age in Avilés, Asturias, Spain. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted in six Health Care Centres. A sample of 400 people was selected, obtained by a random sampling proportional to the population registered in each Health Centre. A review was made of the computerised clinical records, and the STOPP-START (version 2014 with 114 items) criteria were applied to evaluate the PIP. RESULTS: The study contained 378 (95.5%) patients with a mean age of 75.4 (SD: 7.4) and of which 57.7% were women. Almost all (94.2%: 95% CI; 91.7-96.7) met some PIP criteria. Taking only the STOPP criteria into consideration, 52.4% (95%CI: 47.2-57.6) met at least one breach, and in the START criteria a 90.5% (95%CI; 87.4-93.6), which was reduced to 40.5% (95%CI; 36.4-45.6) if criteria on vaccination were removed. In the STOPP criteria, the most frequent PIP was taking benzodiazepines followed by the use of medication without indications based on the evidence; in the START, the criteria was the anti-pneumococcus vaccination, and the lack of taking vitamin D supplements and calcium in osteoporosis. CONCLUSIONS: There were high levels of PIP, very superior to the previous version, especially for the START criteria. There is a high level of PIP related to the use of benzodiazepines and the use of medication without any clinic evidence. The STOPP-START criteria are useful in Primary Care to assess the PIP.