Use of the Screening Tool of Older Persons' Prescriptions (STOPP) and the Screening Tool to Alert doctors to the Right Treatment (START) in hospitalised older people

Aims: To determine the prevalence and nature of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) in patients aged 65 years and over. Method: A retrospective clinical audit was undertaken (N= 200) in an Australian metropolitan teaching hospital. Results: The prevalence of at least one PIM was 51% (n = 101) whereas the prevalence of at least one PPO was 74% (n = 147). The most common PIM was prescribing aspirin to patients with no history of coronary, cerebral or peripheral arterial disease or occlusive arterial events. The most commonly detected PPO was the failure to prescribe statins to patients with a documented history of coronary, cerebral or peripheral vascular disease. Overall, 80 (24%) of the 335 PIMs identified were possibly associated with an adverse clinical outcome experienced by patients. Conclusions: Inappropriate prescribing continues to be a problem as shown by complexities associated with the risk-benefit trade-offs of managing medications in older patients.