Translation and Adaptation of the STOPP/START Criteria Version 3 for Potentially Inappropriate Prescribing in Older People to European Portuguese: A Study Protocol

Authors

  • Daniela A. Rodrigues Biotechnology Research. Innovation and Design for Health Products (BRIDGES). Research Laboratory on Epidemiology and Population Health. Instituito Politécnico da Guarda. Guarda; Health Sciences Research Centre (CICS). Universidade da Beira Interior. Covilhã; Universidad de Salamanca. Salamanca.
  • Fátima Roque Biotechnology Research. Innovation and Design for Health Products (BRIDGES). Research Laboratory on Epidemiology and Population Health. Instituito Politécnico da Guarda. Guarda; Health Sciences Research Centre (CICS). Universidade da Beira Interior. Covilhã.
  • Maria Teresa Herdeiro Department of Medical Sciences. Institute of Biomedicine (iBiMED). Universidade de Aveiro. Aveiro.
  • Luís Monteiro Department of Medical Sciences. Institute of Biomedicine (iBiMED). Universidade de Aveiro. Aveiro; Centre for Health Technology and Services Research (CINTESIS). Faculty of Medicine. Universidade do Porto. Porto; Unidade de Saúde Familiar Esgueira Mais. Unidade Local de Saúde da Região de Aveiro. Aveiro. 

DOI:

https://doi.org/10.20344/amp.21941

Keywords:

Aged, Drug Prescriptions, Inappropriate Prescribing, Portugal, Potentially Inappropriate Medication List, Practice Patterns, Physicians

Abstract

Introduction: As the global population ages, managing medication use in older adults becomes increasingly complex due to polypharmacy and the associated risks of adverse drug events. To improve the safety and appropriateness of medication use in the older population, tools like the Screening Tool of Older Persons’ Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria have been developed. The availability of updated criteria is crucial to better support healthcare professionals in Portuguese-speaking regions. The aim of this study is to translate and validate the STOPP/START version 3 criteria for Portuguese, providing an updated and useful tool for healthcare professionals.
Methods and Analysis: This study will be conducted through four phases: I) translation of the STOPP/START version 3 criteria to European Portuguese; II) collection of sociodemographic, clinical, and medication data; III) intrarater reliability study; and IV) interrater agreement study. This study obtained ethics approval by the Ethics Committee of the Administração Regional de Saúde do Centro, Portugal. The availability of the translated criteria will enable the integration of STOPP/START version 3 into clinical practice in Portugal, facilitating improved medication safety and appropriateness. This integration is expected to lead to better management of polypharmacy and a reduction in adverse drug events, ultimately enhancing patient outcomes and supporting evidence-based prescribing practices.

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References

United Nations. World population prospects 2022. 2022. [cited 2024 Apr 15]. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf.

Rudnicka E, Napierała P, Podfigurna A, Męczekalski B, Smolarczyk R, Grymowicz M. The World Health Organization (WHO) approach to healthy ageing. Maturitas. 2020;139:6-11. DOI: https://doi.org/10.1016/j.maturitas.2020.05.018

Pérez-Jover V, Mira JJ, Carratala-Munuera C, Gil-Guillen VF, Basora J, López-Pineda A, et al. Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases. Int J Environ Res Public Health. 2018;15:310. DOI: https://doi.org/10.3390/ijerph15020310

Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17:230. DOI: https://doi.org/10.1186/s12877-017-0621-2

Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol. 2015;71:1415-27. DOI: https://doi.org/10.1007/s00228-015-1954-4

Motter FR, Fritzen JS, Hilmer SN, Paniz ÉV, Paniz VM. Potentially inappropriate medication in the elderly: a systematic review of validated explicit criteria. Eur J Clin Pharmacol. 2018;74:679-700. DOI: https://doi.org/10.1007/s00228-018-2446-0

Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med. 1991;151:1825-32. DOI: https://doi.org/10.1001/archinte.151.9.1825

Fick D, Semla T, Beizer J, Brandt N, Dombrowski R, DuBeau CE, et al. American Geriatrics Society updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60:616-31. DOI: https://doi.org/10.1111/j.1532-5415.2012.03923.x

Samuel MJ. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63:2227-46. DOI: https://doi.org/10.1111/jgs.13702

Fick DM, Semla TP, Steinman M, Beizer J, Brandt N, Dombrowski R, et al. American Geriatrics Society 2019 updated AGS beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67:674-94. DOI: https://doi.org/10.1111/jgs.15767

American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71:2052-81. DOI: https://doi.org/10.1111/jgs.18372

Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D. STOPP (screening tool of older person’s prescriptions) and START (screening tool to alert doctors to right treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008;46:72-83. DOI: https://doi.org/10.5414/CPP46072

O’mahony D, O’sullivan D, Byrne S, O’connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2. Age Ageing. 2015;44:213-8. DOI: https://doi.org/10.1093/ageing/afu145

O’Mahony D, Cherubini A, Guiteras AR, Denkinger M, Beuscart JB, Onder G, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14:625-32. DOI: https://doi.org/10.1007/s41999-023-00777-y

Aguiar JP, Gama Marques J, Alves da Costa F. Utility and limitations of a screening tool of older person’s prescription among psychiatric elder patients: a comprehensive review. Aging Health Res. 2021;1:100031. DOI: https://doi.org/10.1016/j.ahr.2021.100031

Tian F, Chen Z, Zeng Y, Feng Q, Chen X. Prevalence of use of potentially inappropriate medications among older adults worldwide: a systematic review and meta-analysis. JAMA Netw Open. 2023;6:e2326910. DOI: https://doi.org/10.1001/jamanetworkopen.2023.26910

De Oliveira Martins S, Soares MA, Foppe Van Mil JW, Cabrita J. Inappropriate drug use by Portuguese elderly outpatients - effect of the beers criteria update. Pharmacy World and Science. 2006;28:296-301. DOI: https://doi.org/10.1007/s11096-006-9046-2

Eiras A, Teixeira MA, González-Montalvo JI, Castell MV, Queipo R, Otero Á. Consumption of drugs in over 65 in Porto (Portugal) and risk of potentially inappropriate medication prescribing. Aten Primaria. 2016;48:110-20. DOI: https://doi.org/10.1016/j.aprim.2015.03.005

Simões PA, Santiago LM, Maurício K, Simões JA. Prevalence of potentially inappropriate medication in the older adult population within primary care in Portugal: a nationwide cross-sectional study. Patient Prefer Adherence. 2019;13:1569-76. DOI: https://doi.org/10.2147/PPA.S219346

Monteiro C, Canário C, Ribeiro MÂ, Duarte AP, Alves G. Medication evaluation in Portuguese elderly patients according to beers, stopp/start criteria and EU(7)-PIM list – an exploratory study. Patient Prefer Adherence. 2020;14:795-802. DOI: https://doi.org/10.2147/PPA.S247013

da Costa FA, Periquito C, Carneiro MC, Oliveira P, Fernandes AI, Cavaco-Silva P. Potentially inappropriate medications in a sample of Portuguese nursing home residents: does the choice of screening tools matter? Int J Clin Pharm. 2016;38:1103-11. DOI: https://doi.org/10.1007/s11096-016-0337-y

Peixoto S, Almeida A, Caramelo A, Mendes L. Application of the 2015 beers criteria operationalized for portugal in institutionalized elderly: a crosssectional study. Acta Med Port. 2020;33:741-8. DOI: https://doi.org/10.20344/amp.13030

Aguiar JP, Costa LH, da Costa FA, Leufkens HG, Martins AP. Identification of potentially inappropriate medications with risk of major adverse cardiac and cerebrovascular events among elderly patients in ambulatory setting and long-term care facilities. Clin Interv Aging. 2019;14:535-47. DOI: https://doi.org/10.2147/CIA.S192252

AL-Musawe L, Torre C, Guerreiro JP, Rodrigues AT, Raposo JF, Mota-Filipe H, et al. Polypharmacy, potentially serious clinically relevant drug-drug interactions, and inappropriate medicines in elderly people with type 2 diabetes and their impact on quality of life. Pharmacol Res Perspect. 2020;8:e00621. DOI: https://doi.org/10.1002/prp2.621

Perpétuo C, Plácido AI, Rodrigues D, Aperta J, Piñeiro-Lamas M, Figueiras A, et al. Prescription of potentially inappropriate medication in older inpatients of an internal medicine ward: concordance and overlap among the EU(7)-PIM list and beers and STOPP Criteria. Front Pharmacol. 2021;12:676020. DOI: https://doi.org/10.3389/fphar.2021.676020

Candeias C, Gama J, Rodrigues M, Falcão A, Alves G. Potentially inappropriate medications and potential prescribing omissions in elderly patients receiving post-acute and long-term care: application of screening tool of older people’s prescriptions/screening tool to alert to right treatment criteria. Front Pharmacol. 2021;12:747523. DOI: https://doi.org/10.3389/fphar.2021.747523

Plácido AI, Aguiar A, Piñeiro-Lamas M, Varallo F, Figueiras A, Herdeiro MT, et al. Assessment of potentially inappropriate medications using the EU (7)-PIM List, in a sample of portuguese older adults’ residents in nursing homes. Risk Manag Healthc Policy. 2022;15:1343-52. DOI: https://doi.org/10.2147/RMHP.S346300

Monteiro L, Monteiro-Soares M, Matos C, Ribeiro-Vaz I, Teixeira A, Martins C. inappropriate prescriptions in older people—translation and adaptation to portuguese of the STOPP/START Screening Tool. Int J Environ Res Public Health. 2022;19:6896. DOI: https://doi.org/10.3390/ijerph19116896

Dalleur O, Pharm M, Lang PO, Boland B. La nouvelle version des critères STOPP/START adaptée en français. Pharmactuel. 2016;49:61-4.

Delgado-Silveira E, Molina Mendoza MD, Montero-Errasquín B, García MM, Rodríguez Espeso EA, Vélez-Díaz-Pallarés M, et al. Spanish version of the STOPP/START 3 criteria: Advances in the detection of inappropriate prescribing medication in the older people. Rev Esp Geriatr Gerontol. 2023;58:101407. DOI: https://doi.org/10.1016/j.regg.2023.101407

Vermeulen Windsant-van den Tweel AM, Verduijn MM, Derijks HJJ, van Marum RJ. Detectie van ongeschikt medicatiegebruik bij ouderen; worden de STOPP-en START-criteria de nieuwe standaard? Ned Tijdschr Geneeskd. 2012;156:A5076.

Kojima T, Mizukami K, Tomita N, Arai H, Ohrui T, Eto M, et al. Screening tool for older persons’ appropriate prescriptions in japanese: report of the Japan Geriatrics Society Working Group on “guidelines for medical treatment and its safety in the elderly.” Geriatr Gerontol Int. 2016;16:983-1001. DOI: https://doi.org/10.1111/ggi.12890

Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8:94-104. DOI: https://doi.org/10.1111/j.1524-4733.2005.04054.x

Streiner DL, Norman GR. Biases in responding. In: Health Measurement Scales. Oxford: Oxford University Press; 2009. DOI: https://doi.org/10.1093/acprof:oso/9780199231881.001.0001

Shoukri MM. Measures of interobserver agreement and reliability. Boca Raton: CRC Press; 2010. DOI: https://doi.org/10.1201/b10433

Kottner J, Audige L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. Int J Nurs Stud. 2011;48:661-71. DOI: https://doi.org/10.1016/j.ijnurstu.2011.01.016

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74. DOI: https://doi.org/10.2307/2529310

Laatikainen O, Sneck S, Turpeinen M. Medication-related adverse events in health care—what have we learned? A narrative overview of the current knowledge. Eur J Clin Pharmacol. 2022;78:159-70. DOI: https://doi.org/10.1007/s00228-021-03213-x

Falemban AH. Medication-related problems and their intervention in the geriatric population: a review of the literature. Cureus. 2023:e44594. DOI: https://doi.org/10.7759/cureus.44594

Direção-Geral da Saúde. Norma N.o 018/2016 reconciliação da medicação. 2016. [cited 2024 Aug 07]. Available from: https://normas.dgs.min-saude.pt/wp-content/uploads/2019/10/reconciliacao-da-medicacao.pdf.

Published

2024-11-13

How to Cite

1.
A. Rodrigues D, Roque F, Herdeiro MT, Monteiro L. Translation and Adaptation of the STOPP/START Criteria Version 3 for Potentially Inappropriate Prescribing in Older People to European Portuguese: A Study Protocol. Acta Med Port [Internet]. 2024 Nov. 13 [cited 2024 Dec. 12];37(12):847-52. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/21941

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Section

Study Protocols