Patients' clinical information requirements to apply the STOPP/START criteria
Patients' clinical information requirements to apply the STOPP/START criteria
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DOI：
10.1007/s11096-019-00920-5
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发表时间：
2019-10-29
影响因子：
2.4
通讯作者：
Margarida Castel-Branco, M.
中科院分区：
文献类型：
--
作者：
Carvalho, Rosario;Lavrador, Marta;Margarida Castel-Branco, M.
背景STOPP/START标准是检测潜在不适当药物（PIM）的明确工具。患者临床信息可能并非在所有设置中均可用。目的确定应用STOPP/START标准所需的患者临床信息。背景：葡萄牙的四家疗养院。方法首先，进行理论分析，以确定应用STOPP/START标准（v2）所需的患者信息，根据以下类别：患者的当前用药，用药史（既往用药和持续时间），医疗记录（当前和过去的医疗条件）和实验室检查结果。通过对65岁以上患者的养老院人群进行横断面研究，对信息要求进行了验证。对患者的医疗记录进行评估，仅提取人口统计学数据和当前药物概况。主要成果衡量：《裁减战略武器条约》/《裁减战略武器条约》的信息要求。结果81个STOPP标准中只有29个和34个START标准中只有1个可以仅根据患者的药物信息做出判断。52例STOPP和33例START标准需要额外信息（即治疗持续时间、既往用药、当前和既往医疗状况以及实验室数据）。评价的208人（87岁; 68.75%女性）使用了1770种药物，其中989人（55.9%）可能涉及1629个STOPP标准。只有529例（32.5%）潜在的STOPP标准情况可获得足够的信息来判断STOPP标准，其中397例（75.0%）阳性识别出STOPP PIM。结论虽然STOPP/START标准可以被认为是一个高层次的工具，以确定PIM，他们的使用可能会受到影响的情况下，获得患者的临床信息是有限的。
Background The STOPP/START criteria are an explicit tool to detect potentially inappropriate medications (PIMs). Patient clinical information may not be available in all settings. Objective To identify patient clinical information needed to apply the STOPP/START criteria. Setting: Four nursing homes in Portugal. Methods First, a theoretical analysis was performed to identify the patient information required to apply the STOPP/START criteria (v2), according to the following categories: patients' current medication, medication history (previous medication and duration), medical records (current and past medical conditions), and laboratory test results. A verification of the information requirements was conducted through a cross-sectional study on a nursing home population with patients over 65 years old. Patients' medical records were appraised to extract only demographic data and current medication profiles. Main outcome measure Information requirements of STOPP/START. Results For only 29 of the 81 STOPP criteria and 1 of the 34 START criteria, a judgement could be made with only the information in the patient's medication profile. 52 STOPP and 33 START criteria require additional information, (i.e. duration of therapy, previous medication, current and past medical conditions, and laboratory data). The 208 evaluated persons (87 years; 68.75% female) used 1770 medications, with 989 (55.9%) potentially involved in 1629 STOPP criteria. Sufficient information to judge STOPP criteria was available for only 529 (32.5%) potential STOPP criteria situations, with a positive identification of a STOPP PIM in 397 instances (75.0%). Conclusions Although STOPP/START criteria can be considered a high-level tool to identify PIMs, their use may be compromised in scenarios where access to patients' clinical information is limited.