Los criterios STOPP/START más frecuentes en España. Una revisión de la literatura / The most common STOPP/START criteria in Spain. A review of the literature

Objetivo: Analizar los criterios STOPP/START encontrados con más frecuencia en los estudios llevados a cabo en España, con el fin de identificar las áreas principales de prescripción potencialmente inadecuada. Métodos: Revisión de la literatura de los estudios originales realizados en España que aplicaron los criterios STOPP/START, versión 2008, y que describían los criterios STOPP o START más comunes. En cada estudio, se realizó un análisis ponderado de los criterios encontrados, asignando una puntuación 5 al criterio encontrado en la primera posición, 4 al criterio en segunda posición y así sucesivamente hasta el quinto criterio. Posteriormente se obtuvieron las puntuaciones totales para cada criterio analizado. Resultados: Se seleccionaron 19 estudios originales que analizaban los criterios STOPP, de los cuales 14 analizaban también todos los criterios START. Del total de estudios, 11 se desarrollaron en atención extrahospitalaria y 8 en atención hospitalaria. El criterio STOPP con la valoración ponderada más alta fue el B7 (uso prolongado de benzodiacepinas de vida media larga), seguido del J (cualquier prescripción regular de 2fármacos de la misma clase). El criterio START con la valoración ponderada más alta fue el F4 (estatinas en la diabetes mellitus si coexisten uno o más factores mayores de riesgo cardiovascular), seguido del E3 (suplementos de calcio y vitamina D en pacientes con osteoporosis conocida [con evidencia radiológica o fractura por fragilidad previa o cifosis dorsal adquirida]). Conclusiones: Las áreas de prescripción potencialmente inadecuada están bien definidas y sañalan la pertinencia de intervención en algunos puntos terapéuticos concretos

Objective: To analyse STOPP/START criteria found most frequently in the studies carried out in Spain, in order to identify the main areas of potentially inappropriate prescribing. Methods: A literature review was carried out on the original studies performed in Spain that applied the original version of the STOPP/START criteria and that described the most common STOPP and/or START criteria found. In each study, a weighted analysis was performed on the criteria found, by assigning 5 points to the criterion in first position, 4 points to the criterion in second position, and so on to fifth criterion. The total points of each analysed criterion were then obtained. Results: A total of 19 original studies analysing STOPP criteria were selected, 14 of them also studying all START criteria. From the total of studies, 11 were developed in out-of-hospital care, and 8 in hospital care. The STOPP criterion with the highest weighted assessment was B7 (long-term, long-acting benzodiazepines), followed by J (any duplicate drug class prescription). The START criterion with the highest weighted assessment was F4 (statin therapy in diabetes mellitus if coexisting major cardiovascular risk factors present), followed by E3 (calcium and vitamin D supplement in patients with known osteoporosis: previous fragility fracture, acquired dorsal kyphosis). Conclusions: The most common areas of potentially inappropriate prescribing are well defined, and suggest a particular intervention in some specific therapeutic points

[The most common STOPP/START criteria in Spain. A review of the literature]. / Los criterios STOPP/START más frecuentes en España. Una revisión de la literatura.

OBJECTIVE: To analyse STOPP/START criteria found most frequently in the studies carried out in Spain, in order to identify the main areas of potentially inappropriate prescribing. METHODS: A literature review was carried out on the original studies performed in Spain that applied the original version of the STOPP/START criteria and that described the most common STOPP and/or START criteria found. In each study, a weighted analysis was performed on the criteria found, by assigning 5 points to the criterion in first position, 4 points to the criterion in second position, and so on to fifth criterion. The total points of each analysed criterion were then obtained. RESULTS: A total of 19 original studies analysing STOPP criteria were selected, 14 of them also studying all START criteria. From the total of studies, 11 were developed in out-of-hospital care, and 8 in hospital care. The STOPP criterion with the highest weighted assessment was B7 (long-term, long-acting benzodiazepines), followed by J (any duplicate drug class prescription). The START criterion with the highest weighted assessment was F4 (statin therapy in diabetes mellitus if coexisting major cardiovascular risk factors present), followed by E3 (calcium and vitamin D supplement in patients with known osteoporosis: previous fragility fracture, acquired dorsal kyphosis). CONCLUSIONS: The most common areas of potentially inappropriate prescribing are well defined, and suggest a particular intervention in some specific therapeutic points.