What tools are available to assist prescribers when treating the elderly?
To help providers minimize the risk of medication-related negative outcomes, multiple screening tools as well as a list of medications with known potential for greater risk than benefit in the elderly have been developed.
The Screening Tool of Older People’s Potentially Inappropriate Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatments (START) consist of 114 evidence-based criteria (80 STOPP and 34 START) that are categorized by physiologic system and assist prescribers in preventing inappropriate prescribing and polypharmacy.
The American Geriatrics Society Beers Criteria, recently updated in 2015, provide prescribers with evidence-based tables of reference. Table 1 lists medications that are potentially inappropriate for use in older adults, independent of specific medical conditions. Table 2 considers specific diagnoses and lists certain common medical conditions and medications that may be potentially inappropriate due to drug-disease interactions. In the 2015 update, two additional tables were added, one with common drug-drug interactions seen in the elderly, and another with medications that require dose adjustment based on renal function/creatinine clearance.