title: Long-Term Outcomes of Medication Intervention Using the Screening Tool of Older Persons Potentially Inappropriate Prescriptions Screening Tool to Alert Doctors to Right Treatment Criteria.
abstract: OBJECTIVE
  To compare 24-month outcomes of participants of a prospective randomized controlled trial (RCT) assigned to undergo a medication intervention of orally communicated recommendations based on Screening Tool of Older Persons potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatment (START) (intervention group) with outcomes of those assigned to undergo written medication review (control group).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Chronic care geriatric facility.
  
  
  METHODS
  Of 359 participants from a prospective RCT conducted between April 2012 and September 2013, 306 were evaluable for another 12-month follow-up.
  
  
  METHODS
  Outcomes at 24-month follow-up included quality of prescribing (assessed according to STOPP/START), hospitalizations, falls, costs of medications, and all-cause mortality. Outcomes were compared with those reported at the beginning (baseline) and end (12-month follow-up) of the RCT.
  
  
  RESULTS
  There was a significant rise in potentially inappropriate prescriptions (PIPs) (P = .01) and potentially prescriptions omissions (PPOs) (P < .001) in the intervention group between 12 and 24 months, although the prevalence of PIPs was significantly lower in the intervention group (33.3%) than the control group (48.4%) at 24-month follow-up (P = .02). Costs of medications were significantly lower in the intervention group than the control group (P < .001) at 24-month follow-up. The average number of falls in both groups dropped significantly between baseline and study closure (P = .04 and P = .008, respectively). There was no significant difference in hospitalizations and mortality between the two groups at 24-month follow-up.
  
  
  CONCLUSIONS
  The effect of an orally communicated medication intervention with the STOPP/START criteria on falls was maintained over time. Direct communication between pharmacists and prescribing physicians is more efficient than written medication review and is recommended every 6 months in geriatric facilities.
authors.affiliation: Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
authors.forename: Dvora
authors.initials: D
authors.lastname: Frankenthal
authors.affiliation: Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
authors.forename: Avi
authors.initials: A
authors.lastname: Israeli
authors.affiliation: Clinical Pharmacology Unit, Division of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem.
authors.forename: Yoseph
authors.initials: Y
authors.lastname: Caraco
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
authors.forename: Yaffa
authors.initials: Y
authors.lastname: Lerman
authors.affiliation: "Givat Hashlosha" Geriatric Hospital, Petah Tiqva.
authors.forename: Edward
authors.initials: E
authors.lastname: Kalendaryev
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.|Department of Medicine 'C, ' Wolfson Medical Centre, Holon, Israel.
authors.forename: Gisele
authors.initials: G
authors.lastname: Zandman-Goddard
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Lerman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016527:Drug Costs; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D007557:Israel; D008297:Male; D000067561:Potentially Inappropriate Medication List; D012189:Retrospective Studies
keywords: START criteria; STOPP criteria; elderly; inappropriate prescribing