TY - JOUR
T1 - Medication Appropriateness for Older Nursing Home Patients With a Limited Life Expectancy
T2 - From STOPP/START Version 2 to the ReNeWAL Criteria
AU - Dijk, Margaretha T.
AU - A.M. Pouw, Catharina
AU - Hertogh, Cees M. P. M.
AU - van Marum, Rob J.
AU - Hugtenburg, Jacqueline G.
AU - Smalbrugge, Martin
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/9/1
Y1 - 2024/9/1
N2 - Objectives: 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. Design: A modified Delphi consensus study. Setting and Participants: The study was established in The Netherlands and conducted online. The international panel consisted of 23 experts with experience in medicine for older people. Methods: 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. Results: 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. Conclusion and Implications: 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.
AB - Objectives: 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. Design: A modified Delphi consensus study. Setting and Participants: The study was established in The Netherlands and conducted online. The international panel consisted of 23 experts with experience in medicine for older people. Methods: 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. Results: 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. Conclusion and Implications: 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.
KW - Delphi consensus study
KW - STOPP/START criteria
KW - limited life expectancy
KW - nursing home residents
KW - older people
KW - represcribing
UR - http://www.scopus.com/inward/record.url?scp=85199387353&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2024.105143
DO - 10.1016/j.jamda.2024.105143
M3 - Article
C2 - 38996809
SN - 1525-8610
VL - 25
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 9
M1 - 105143
ER -
