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Better prescriping for patient safety

7 December 2010

A new system stands to reduce the prescription of unnecessary, or potentially harmful, drugs to older people when admitted to hospital, thereby improving patient safety and substantially reducing prescription costs.

Researchers in University College Cork confirmed the validity of the new medication review system, called STOPP (Screening Tool of Older Persons? potentially inappropriate Prescriptions) and START (Screening Tool to Alert to Right Treatment).

It was created to help doctors and pharmacists avoid potential prescribing errors in older patients and to highlight when practitioners do not prescribe medication that would actually be of benefit to this age group.

The research looked at clinical and prescription details relating to more than 700 older patients in an acute hospital setting and applied the STOPP/START criteria.

?We found that one in every three of these patients received at least one potentially inappropriate drug,? says lead researcher Dr Paul Gallagher. ?A third of this group displayed symptoms attributable to adverse side effects of inappropriately prescribed drugs. We also found that over 40 per cent of patients were not receiving appropriate medication for common conditions including diabetes, stroke and osteoporosis.

?By comparing the findings with similar cohorts of patients in six other European cities and getting similar results, the UCC group has helped to highlight the issue of inappropriate prescribing internationally as part of the global need to improve the quality and safety of prescribing practices.

STOPP/START recommendations and criteria have now been implemented as an audit tool in several countries, resulting in significant improvements in prescribing quality. Further research is underway to find out if routine application of STOPP/STARTcriteria reduces adverse drug reactions and prescription costs among older people admitted to hospital.


  • Safer and more appropriate prescribing practices for older patients.
  • Less wastage of prescription drugs.
  • Reduced cost burden of prescription drugs.

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