Table 1 STOPP screening criteria [22]
STOPP criteria | |
|---|---|
A. Cardiovascular system | |
1 | Digoxin at a long-term dose >125 mg/d with impaired renal function |
2 | Loop diuretic as first-line monotherapy for hypertension or for dependent ankle edema only |
3 | Thiazide diuretic with a history of gout |
4 | Noncardioselective b-blocker with chronic obstructive pulmonary disease |
5 | b-blocker in combination with verapamil |
6 | Use of diltiazem or verapamil with New York Heart Association class 3 or 4 heart failure |
7 | Calcium-channel blockers with chronic constipation |
8 | Use of aspirin and warfarin in combination without histamine H2 receptor antagonist |
(except cimetidine) or proton pump inhibitor | |
9 | Dipyridamole as monotherapy for cardiovascular secondary prevention |
10 | Aspirin with no history of coronary, cerebral or peripheral vascular symptoms |
or occlusive arterial event or with a past history of peptic ulcer disease | |
without histamine H2 receptor antagonist or proton pumpinhibitor or at dose >150 mg/d | |
or to treat dizziness not clearly attributed to cerebrovascular disease | |
11 | Warfarin for first, uncomplicated deep venous thrombosis for longer than 6-month duration |
or for first, uncomplicated pulmonary embolus for longer than 12-month duration | |
12 | Aspirin, clopidogrel, dipyridamole, or warfarin with concurrent bleeding disorder |
B. CNS and psychotropic drugs | |
1 | Tricyclic antidepressants with dementia or with glaucoma or with cardiac conductive abnormalities |
or with constipation or with prostatism or prior history of urinary retention or with an opiate | |
or calcium-channel blocker | |
2 | Long-term (>3 month) use of long-acting benzodiazepines, and with long-acting metabolites |
3 | Long-term (>1 month) neuroleptics as long-term hypnotics or in those with parkinsonism |
4 | Phenothiazines in patients with epilepsy |
5 | Anticholinergics to treat extrapyramidal side effects of neuroleptic medications |
6 | Selective serotonin reuptake inhibitors with a history of clinically significant hyponatremia |
(noniatrogenic hyponatremia <130 mmol/L within the previous 2 months) | |
7 | Prolonged use (>1 week) of first-generation antihistamines |
C. Gastrointestinal system | |
1 | Diphenoxylate, loperamide or codeine phosphate for treatment of diarrhea of unknown cause |
or severe infective gastroenteritis | |
2 | Prochlorperazine or metoclopramide with parkinsonism |
3 | Proton pump inhibitors for peptic ulcer disease at full therapeutic dosage for >8 weeks |
4 | Anticholinergic antispasmodic drugs with chronic constipation |
D. Respiratory system | |
1 | Theophylline as monotherapy for chronic obstructive pulmonary disease |
2 | Systemic corticosteroids instead of inhaled corticosteroids for maintenance therapy |
in moderate-to-severe chronic obstructive pulmonary disease | |
3 | Nebulized ipratropium with glaucoma |
E. Musculoskeletal system | |
1 | NSAID with history of peptic ulcer disease or gastrointestinal bleeding, unless with concurrent |
histamine H2 receptor antagonist, proton pump inhibitor, or misoprostol | |
2 | NSAID with moderate-to-severe hypertension or with heart failure |
3 | Long-term use of NSAID (>3 months) for relief of mild joint pain in osteoarthritis |
4 | Warfarin and NSAID together |
5 | NSAID with chronic renal failure |
6 | Long-term corticosteroids (>3 months) as monotherapy for rheumatoid arthritis |
or osteoarthritis | |
7 | Long-term NSAID or colchicine for chronic treatment of gout where there is |
no contraindication to allopurinol | |
F. Urogenital system | |
1 | Bladder antimuscarinic drugs with dementia or with chronic glaucoma |
or with chronic constipation or with chronic prostatism | |
2 | a-blockers in males with frequent incontinence |
3 | a-blockers with long-term urinary catheter in situ (>2 months) |
G. Endocrine system | |
1 | Glibenclamide or chlorpropamide with type 2 diabetes mellitus |
2 | b-blockers in those with diabetes mellitus and frequent hypoglycemic episodes |
3 | Estrogens with a history of breast cancer or venous thromboembolism |
4 | Estrogens without progestogen in patients with intact uterus |
H. Drugs that adversely affect those prone to falls (at least 1 fall in past 3 months) | |
1 | Benzodiazepines |
2 | Neuroleptic drugs |
3 | First-generation antihistamines |
4 | Vasodilator drugs known to cause hypotension in those with persistent postural hypotension |
5 | Long-term opiates in those with recurrent falls |
I. Analgesic drugs | |
1 | Use of long-term powerful opiates as first-line therapy for mild-to-moderate pain |
2 | Regular opiates for more than 2 weeks in those with chronic constipation |
without concurrent use of laxatives | |
3 | Long-term opiates in those with dementia unless indicated for palliative care |
or management of moderate-to-severe chronic pain syndrome | |
J. Duplicate drug classes | |
1 | Any regular duplicate drug class prescription, such as two concurrent opiates, NSAIDs, |
serotonin-specific reuptake inhibitors, loop diuretics, and ACE inhibitors | |