title: Appropriateness of medication prescribing using the STOPP/START criteria in veterans receiving home-based primary care.
abstract: OBJECTIVE
  To evaluate the appropriateness/inappropriateness of medication prescribing using the Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria in elderly homebased primary care (HBPC) veterans and to understand the potential impact of the HBPC team on the STOPP/START criteria.
  
  
  METHODS
  Retrospective chart review between September 1, 2007, and September 30, 2009.
  
  
  METHODS
  Edward Hines, Jr. VA Hospital, Hines, Illinois, a tertiary care referral center.
  
  
  METHODS
  Two hundred patients 65 years of age and older who had an initial interdisciplinary evaluation conducted by the HBPC team. Exclusion criteria included admission to the hospital between the initial and follow-up medication review, admission to the HBPC program for palliative or hospice care, or death before completion of a follow-up evaluation.
  
  
  METHODS
  Appropriateness/inappropriateness of medication prescribing was assessed by comparing the medication list at the initial pharmacist medication review and follow-up review. Initial and follow-up STOPP and START scores were calculated for each patient.
  
  
  METHODS
  The primary outcome was to evaluate the appropriateness/inappropriateness of medication prescribing using the STOPP/START criteria. The secondary outcome was to understand the potential impact of the HBPC team on the STOPP/START criteria.
  
  
  RESULTS
  There was a statistically significant decrease in the STOPP score between the initial and follow-up medication review (P = 0.0014). There was not a statistically significant increase in the START score between the initial and follow-up medication review (P = 0.5720).
  
  
  CONCLUSIONS
  A statistically significant decrease in the STOPP score was found. Although the START score increased, the change was not found to be statistically significant.
authors.affiliation: Edward Hines, Jr. VA Hospital, Hines, IL, USA. millie.brahmbhatt@va.gov
authors.forename: Millie
authors.initials: M
authors.lastname: Brahmbhatt
authors.forename: Kavita
authors.initials: K
authors.lastname: Palla
authors.forename: Annette
authors.initials: A
authors.lastname: Kossifologos
authors.forename: Dayna
authors.initials: D
authors.lastname: Mitchell
authors.forename: Todd
authors.initials: T
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D012189:Retrospective Studies; D014728:Veterans