Bastiaan Sallevelt

67 Evaluation of clarity of the STOPP/START criteria Table 1. Continued. Barriers Example a (clarity rating, %) Sign - Measurement or scores were not described unambiguously STOPP H2. …with severe hypertension or severe heart failure (33%) START E1. …with active, disabling rheumatoid disease (42%) Symptom - Symptoms were not described unambiguously STOPP K-section. Not clear whether the occurrence of ‘falls’ - as mentioned only in the title of section K - is a prerequisite for the applicability of the recommendation or only used to address the increased risk of falls. If ‘falls’ is considered a condition, the frequency of ‘falls’ is not specified. (0%) STOPP D10. …unless sleep disorder is due to (33%) START C2. …with persistent major depressive symptoms (33%) Laboratory finding - Parameters lack clear cut-off levels with reference ranges START C6. …once iron deficiency and severe renal failure have been excluded (33%) EXPLANATION Risk of continuing therapy not clearly described: explanation does not cover clinical relevance of benefit / harm balance (specific adverse drug reactions, toxicity). STOPP D7. ...(risk of anticholinergic toxicity) (17%) START N/A Facilitators Example a (clarity rating, %) ACTION Drugs were specified on individual drug level and -if necessary- route / dosage was specified STOPP C7. Ticlopidine… (100%) START A2. Aspirin (75 mg – 160 mg once daily)… (92%) CONDITION Medication – see also action Specific description of drug therapy (substance / dosage) to clearly identify the target population (i.e. patients using a certain drug regimen). STOPP B3. …in combination with verapamil or diltiazem (92%) START I2. …at least once after age 65 according to national guidelines (83%) 2