Deprescribing in older people approaching end-of-life: development and validation of STOPPFrail version 2. (30th September 2020)

• Record Type: Journal Article
• Authors: Curtin, Denis; Gallagher, Paul; O'Mahony, Denis
• Is Part Of: Age and ageing. Volume 50:Number 2(2021)
• Page Start: 465
• Page End: 471
• Publication Date: 2020-09-30
• Subjects: STOPPFrail -- deprescribing -- frailty -- end-of-life -- older people; Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afaa159
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: Background: Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) criteria were developed in 2017 to assist physicians with deprescribing decisions in older people approaching end-of-life. Updating was required to make the tool more practical, patient-centred and complete. Methods: a thorough literature review was conducted to, first, devise a practical method for identifying older people who are likely to be approaching end-of-life, and second, reassess and update the existing deprescribing criteria. An eight-member panel with a wide-ranging experience in geriatric pharmacotherapy reviewed a new draft of STOPPFrail and were invited to propose new deprescribing criteria. STOPPFrail version 2 was then validated using Delphi consensus methodology. Results: STOPPFrail version 2 emphasises the importance of shared decision-making in the deprescribing process. A new method for identifying older people who are likely to be approaching end-of-life is included along with 25 deprescribing criteria. Guidance relating to the deprescribing of antihypertensive therapies, anti-anginal medications and vitamin D preparations comprises the new criteria. Conclusions: STOPPFrail criteria have been updated to assist physicians in efforts to reduce drug-related morbidity and burden for their frailest older patients. Version 2 is based on an up-to-date literature review and consensus validation by a panel of experts.