Computer-generated STOPP/START recommendations for hospitalised older adults: evaluation of the relationship between clinical relevance and rate of implementation in the SENATOR trial

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dc.contributor.author Dalton, Kieran
dc.contributor.author Curtin, Denis
dc.contributor.author O'Mahony, Denis
dc.contributor.author Byrne, Stephen
dc.date.accessioned 2020-08-12T09:27:12Z
dc.date.available 2020-08-12T09:27:12Z
dc.date.issued 2020-06-02
dc.identifier.citation Dalton, K., Curtin, D., O'Mahony, D. and Byrne, S. (2020) 'Computer-generated STOPP/START recommendations for hospitalised older adults: evaluation of the relationship between clinical relevance and rate of implementation in the SENATOR trial', Age and Ageing, 49(4), pp. 615-621. doi: 10.1093/ageing/afaa062 en
dc.identifier.volume 49 en
dc.identifier.issued 4 en
dc.identifier.startpage 615 en
dc.identifier.endpage 621 en
dc.identifier.issn 0002-0729
dc.identifier.uri http://hdl.handle.net/10468/10382
dc.identifier.doi 10.1093/ageing/afaa062 en
dc.description.abstract Background: findings from a recent qualitative study indicate that the perceived clinical relevance of computer-generated STOPP/START recommendations was a key factor affecting their implementation by physician prescribers caring for hospitalised older adults in the SENATOR trial. Aim: to systematically evaluate the clinical relevance of these recommendations and to establish if clinical relevance significantly affected the implementation rate. Methods: a pharmacist–physician pair retrospectively reviewed the case records for all SENATOR trial intervention patients at Cork University Hospital and assigned a degree of clinical relevance for each STOPP/START recommendation based on a previously validated six-point scale. The chi-square test was used to quantify the differences in prescriber implementation rates between recommendations of varying clinical relevance, with statistical significance set at P < 0.05. Results: in 204 intervention patients, the SENATOR software produced 925 STOPP/START recommendations. Nearly three quarters of recommendations were judged to be clinically relevant (73.6%); however, nearly half of these were deemed of ‘possibly low relevance’ (320/681; 47%). Recommendations deemed of higher clinical relevance were significantly more likely to be implemented than those of lower clinical relevance (P < 0.05). Conclusions: a large proportion (61%) of the computer-generated STOPP/START recommendations provided were of potential ‘adverse significance’, of ‘no clinical relevance’ or of ‘possibly low relevance’. The adjudicated clinical relevance of computer-generated medication recommendations significantly affects their implementation. Meticulous software refinement is required for future interventions of this type to increase the proportion of recommendations that are of high clinical relevance. This should facilitate their implementation, resulting in prescribing optimisation and improved clinical outcomes for multimorbid older adults. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Oxford University Press en
dc.relation.uri https://academic.oup.com/ageing/advance-article-abstract/doi/10.1093/ageing/afaa062/5847547?redirectedFrom=fulltext
dc.rights © 2020, the Authors. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record [Dalton, K., Curtin, D., O'Mahony, D. and Byrne, S. (2020) 'Computer-generated STOPP/START recommendations for hospitalised older adults: evaluation of the relationship between clinical relevance and rate of implementation in the SENATOR trial', Age and Ageing, 49(4), pp. 615-621. doi: 10.1093/ageing/afaa062] is available online at: https://doi.org/10.1093/ageing/afaa062 en
dc.subject Prescribing en
dc.subject Aged en
dc.subject Hospital en
dc.subject STOPP/START en
dc.subject Pharmacotherapy en
dc.subject Older people en
dc.title Computer-generated STOPP/START recommendations for hospitalised older adults: evaluation of the relationship between clinical relevance and rate of implementation in the SENATOR trial en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Kieran Dalton, School Of Pharmacy, University College Cork, Cork, Ireland. +353-21-490-3000 Email: kieran.dalton@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2021-06-02
dc.date.updated 2020-08-12T09:17:07Z
dc.description.version Accepted Version en
dc.internal.rssid 517085256
dc.contributor.funder Seventh Framework Programme en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Age and Ageing en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress kieran.dalton@ucc.ie en
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/305930/EU/Development and clinical trials of a new Software ENgine for the Assessment & Optimization of drug and non-drug Therapy in Older peRsons/SENATOR en
dc.identifier.eissn 1468-2834


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