284 CHAPTER 4.1 In total, 68 of the 79 implemented STOPP criteria and 29 of the 31 START criteria generated a signal by the CDSS based on actual medical data on diagnosis, medication use, measurements, and laboratory values. The ten most frequently generated STOPP and START signals and their subsequent acceptance as well as the eleven STOPP and two START signals that were never generated are listed in Table 2. Acceptance of STOPP/START signals Overall, the pharmacotherapy team accepted 39.1% (n=1,990) of all 5,080 generated STOPP/START signals which corresponds with a median of 2 (IQR 1–3) per patient. The team accepted 40.1% (n=1,390) STOPP signals resulting in a recommendation to the attending hospital physician and the patient. The median number of accepted STOPP signals was 1 (IQR 0–2) per patient. The team accepted 37.2% (n=600) START signals resulting in a recommendation to initiate a drug (median 0; IQR 0–1). In general, there was high variability in the acceptance of individual STOPP/START signals. Acceptance of the top ten most frequently generated STOPP/START signals ranged from 2.5%-75.8%. STOPP A1 (‘Stop any drug prescribed without an evidencebased clinical indication’) covered 28% of all generated signals with more than half of the signals accepted (54%). Drugs for acid related disorders were the drug class most often recommended for discontinuation based on STOPP A1 (22.5%) followed by mineral supplements (calcium) (8.0%) and psychoanaleptics (7.3%). Figure 3 shows the drug classes recommended for discontinuation based on STOPP A1. Figure 2. Distribution of drugs on ATC-2 level that were recommended for discontinuation because of a lack of an evidence-based clinical indication (STOPP A1). Drugs that resulted in a recommendation <20 times were categorized as ‘X00 Other’. 766 out of 1412 generated STOPP A1 signals were accepted by the pharmacotherapy team.
RkJQdWJsaXNoZXIy MTk4NDMw