Identifying Explicit Criteria for the Prevention of Falls

Abstract

Over the last 25 years, several lists of potentially inappropriate medications (PIMs) for older patients have been validated and published with a view to using them as screening tools in clinical practice. Explicit criteria were developed as a guide for avoidance of PIMs and to supplement the physician’s clinical knowledge and expertise in routine clinical practice. These explicit criteria typically do not require detailed or specialist knowledge to be used effectively. Most lists have been developed using the Delphi process. Beers criteria, developed in the United States and updated in 2015, include 88 medications and medication classes, which are divided into 5 categories. Screening Tool of Older Person’s potentially inappropriate Prescriptions (STOPP) and the Screening Tool to Alert doctors to the Right Treatments (START) were developed in Ireland in 2008 and most recently updated in 2014. STOPP includes 80 criteria and there are 34 START criteria. Norwegian General Practice (NORGEP) criteria were developed in 2009 and include 36 criteria based on the Beers list. PRISCUS list medications are listed by pharmacological category rather than by physiological system, along with details of their potential danger as well as alternative medications that are likely safer. The combination of the Beers criteria and STOPP criteria may offer a more complete list. None of the published explicit criteria sets was designed specifically as a fall prevention tool.