STOPPSTARTkriterier

STOPPkriterier and STARTkriterier, commonly referred to as STOPP/START criteria, are explicit tools used to assess medication regimens in older adults. The STOPP list identifies potentially inappropriate prescriptions that should be reconsidered, while the START list highlights potentially beneficial medications that are omitted and should be considered. Used together, they aim to optimize pharmacotherapy, reduce polypharmacy, and lower adverse drug events.

Originating from research on geriatrics and pharmacology, STOPP/START were developed to support structured medication reviews in primary care, hospitals, and long-term care. The approach has been widely adopted in many countries and has been translated into several languages. Version 2 of the criteria expands and refines the items to reflect current evidence and prescribing practices.

Content and use: The STOPP criteria cover patterns of inappropriate prescribing, including drug-drug interactions, drug-disease contraindications, and therapeutic duplications in the context of common geriatric conditions. The START criteria specify situations where a beneficial treatment is omitted despite indications in older patients. Together, they provide a framework for clinicians to question existing prescriptions and consider appropriate additions.

Limitations and implementation: While helpful, STOPP/START are explicit criteria that complement clinical judgment rather than replace it. They may require adaptation to local guidelines, drug formularies, and patient preferences. Successful implementation often involves structured medication reviews, clinician education, and, where feasible, integration into electronic prescribing tools.