DescriptionPurpose of the project: Polypharmacy and prescribing of potentially inappropriate medication is a problem in older adults, which leads to negative health outcomes. This project aims to reduce inappropriate polypharmacy by implementing a Screening Tool to Older Person’s Prescriptions (STOPP) and a Screening Tool to Alert Providers to the Right Treatment (START) when prescribing and reviewing medication.
Methodology: This quality improvement project occurred at a primary care clinic in Clifton New Jersey. Providers were introduced and educated on the use of the STOPP/START tool. A two-month retrospective and prospective chart review were conducted based on the number of medications, potentially inappropriate medication (PIM), potentially prescription omission (PPO). Independent t-test and chi-square were used to compare the differences before and after using STOPP/START tool.
Results: A total patient (n=126) was analyzed with records from the retrospective (n=63) and prospective review (n=63). After using STOPP/START tool, number of medications was statistically significant decreased (t₁₂₄=-1.66, p=0.05). PPO statistically significant decreased from 17.5 % to 6.3% (x²⁽¹⁾=3.71, p=0.05). There was no significant reduction of PIM (x²⁽¹⁾=1.64, p=0.201). However, the incidence of PIM decreased from 44.4% in retrospective to 33.3% in prospective group. Implication for practice: Using tools like STOPP/START for a medication review and prescribing will not only prevent inappropriate polypharmacy but will improve providers' skills when prescribing. This will result in greater overall health outcomes for patients, more effective and efficient medication reconciliation practices; seeing an impact in this area should reduce the number of serious medical conditions associated with improper medication practices.