99 Evaluation of clarity of the STOPP/START criteria - SI Table SI1.4 STOPP - Clarity rating of explanations, from lowest to highest ranking. STOPP Explanation Clarity rating n=77 M1 (risk of increased antimuscarinic/anticholinergic toxicity) 17% A3 (optimisation of monotherapy within a single drug class should be observed prior to considering a new agent). 33% B6 (lack of outcome data for this indication; safer, more effective alternatives available). 33% D9 (increased risk of stroke). 33% F2 (dose reduction or earlier discontinuation indicated). 33% H6 (xanthine-oxidase inhibitors are first choice prophylactic drugs in gout). 33% L1 (WHO analgesic ladder not observed). 33% D2 (higher risk of adverse drug reactions with TCAs than with SSRIs or SNRIs). 42% H3 (simple analgesics preferable and usually as effective for pain relief) 42% B10 (centrally-active antihypertensives are generally less well tolerated by older people than younger people). 50% D1 (risk of worsening these conditions). 50% D7 (risk of anticholinergic toxicity), 50% G3 (may cause urinary retention). 50% B1 (no clear evidence of benefit). 58% B9 (may exacerbate incontinence). 58% C3 (high risk of bleeding).. 58% H4 (risk of systemic corticosteroid side-effects). 58% H5 (risk of systemic corticosteroid side-effects). 58% K1 (sedative, may cause reduced sensorium, impair balance). 58% K2 (may cause gait dyspraxia, Parkinsonism). 58% K4 (may cause protracted daytime sedation, ataxia). 58% B13 (risk of cardiovascular collapse). 67% C6 (no added benefit from dual therapy). 67% C10 (risk of gastrointestinal bleeding). 67% C11 (increased risk of peptic ulcer disease) 67% D10 (risk of confusion, hypotension, extra-pyramidal side effects, falls). 67% E1 (risk of digoxin toxicity if plasma levels not measured). 67% 2
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