Optimizing medication use in elderly people in primary care: Impact of STOPP criteria on inappropriate prescriptions

Background: STOPP (Screening Tool of Older Person's Prescriptions) criteria have been used in acute care and nursing home settings as a screening tool to assess Potentially Inappropriate Medication (PIM) for elderly people. Furthermore, this tool could help General Practitioners (GPs) to lower PIM frequency in primary care. Objective: The aim of the study was to measure the impact of STOPP criteria applied by the GP on prescriptions during a primary care consultation. Setting, subjects and method: Twenty GPs were involved and trained to use STOPP criteria. GPs were asked to use STOPP criteria for elderly patients (> 75 years old) who were taking at least five different drugs, seen over a two-month period. The rate of PIM according to STOPP criteria was measured before and after training. Prescription quality was compared using the Medication Appropriateness Index (MAI) score. Results: Overall, 172 prescriptions were analyzed. A total of 170 PIM were identified according to STOPP criteria before the intervention. Fifty-seven percent of the population (n = 98 patients) had at least one PIM. GP's intervention decreased the number of PIM according to STOPP criteria to 106 and was beneficial for 44.9% of the patients (n = 44). The mean MAI score of all medications and PIM decreased by 14.3% (p < 0.001) and 39.1% (p < 0.001) respectively. Discussion conclusions: Application of STOPP criteria by GPs is an effective tool to decrease PIM and MAI score in primary care. The generalization of the use of STOPP criteria during GP consultation should be fostered.