121 Conversion of STOPP/START version 2 into coded algorithms Criterion Original criterion text Additional (excluding) condition Justification START E2 Bisphosphonates and vitamin D and calcium in patients taking long-term systemic corticosteroid therapy Treatment duration >3 months for corticosteroids (only taken into account when starting date is entered) ‘Long-term’ not defined. Cut-off duration of 3 months was chosen, according to the Dutch local version. G1, G2 Start alpha-1 receptor blocker and/or start 5-alpha reductase inhibitor with symptomatic prostatism, where prostatectomy is not considered necessary. ICD-9 code ‘prostatectomy’ present as excluding condition Condition ‘where prostatectomy is not considered necessary’ not codable. Status post-prostatectomy was defined as (additional) excluding condition STOPP B1 Stop digoxin for heart failure with normal systolic ventricular. ICD-10 code I48* ‘atrial fibrillation’ is encoded as additional condition, excluding this rule. In patients suffering from both heart failure and atrial fibrillation, digoxin is most likely prescribed for atrial fibrillation. B6 Loop diuretic as first-line treatment for hypertension. ICD-10 code I50* ‘heart failure’ is encoded as additional condition, excluding this rule. In patients suffering from both hypertension and heart failure, loop diuretics are most likely prescribed for heart failure. B7 Loop diuretic for dependent ankle edema without clinical, biochemical evidence or radiological evidence of heart failure, liver failure, nephrotic syndrome or renal failure. ICD-10 code I50* ‘heart failure’ is encoded as additional condition, excluding this rule. In patients with ankle edema and concomitant diagnosis of heart failure, loop diuretics are most likely prescribed for heart failure. B9 Loop diuretic for treatment of hypertension with concurrent urinary incontinence. See explanation STOPP B6. 2
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