Observational studyAging clinical and experimental research2023
Inappropriate prescribing in geriatric rural primary care: impact on adverse outcomes and relevant risk factors in a prospective observational cohort study.
Observational study in Aging clinical and experimental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 7 citations in OpenAlex.
- Potentially Inappropriate Medication Use in Older Adults: Concordance Among the Chinese and AGS/Beers and STOPP Criteria.Journal of clinical medicine · 2026Article
- Screening criteria of potentially inappropriate medications and associations of exposure timing with incident hospital admissions among older adults in a rural community hospital.BMC geriatrics · 2025Article
- Medication Use by Older Adults with Frailty: A Scoping Review.Pharmacy (Basel, Switzerland) · 2025Review
- A Prospective Study on Potentially Inappropriate Drug Use and All-Cause Mortality in Community-Dwelling Older Adults.Journal of the American Geriatrics Society · 2025Article
- Factors Influencing General Practitioners' Deprescribing Decisions for Older Adults, with Insights into Frailty: a Qualitative Study in Greek Primary Care.Drugs & aging · 2025Article
- Article
- Inter-rater agreement for detection of potentially inappropriate medication according to explicit and implicit STOPP criteria.British journal of clinical pharmacology · 2025Article
- Defining, identifying and addressing problematic polypharmacy within multimorbidity in primary care: a scoping review.BMJ open · 2024Article
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral tools have revealed an association between potentially inappropriate medications (PIM) and adverse outcomes, but the one most fitted for the rural population has not been determined.
aimsWe investigated the performance of the Screening Tool of Older Persons' Prescriptions (STOPP) and Screening Tool to Alert doctors to the Right Treatment (START) in identifying inappropriate prescribing and its association with adverse outcomes among older rural primary health care users.
methodsA cohort of consenting outpatients aged ≥ 65 years in a rural Greek primary care center was assessed for PIM and potential prescribing omissions (PPO) using the START/STOPP version 2 criteria. Medications, comorbidities, functional status, and laboratory data were recorded along with 6-month incidence of emergency department visits, hospitalization, and death prospectively.
resultsAmong 104 participants (median age 78 years, 49.1% women, receiving a median of 6 drugs), PPO was found in 78% and PIMs in 61%. PIM was multivariately correlated with multimorbidity (p = 0.029) and polypharmacy (p < 0,001), while drug-PPO was only associated with multimorbidity (p = 0.039). The number of PIM predicted emergency department visits and hospitalizations at 6-month follow-up (p value 0.011), independent of age, sex, frailty, comorbidities, and total medication number. DISCUSSION: The START/STOPP tool is useful in identifying inappropriate prescribing patterns leading to increased utilization of acute care services in older adults followed at a rural primary care setting.
conclusionInappropriate prescribing as identified by the START/STOPP criteria is prevalent among older adults with multimorbidity in rural primary care, and independently associated with future acute care visits.
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