Optimizing Medication Regimens in Older Adults: A Deprescribing DNP Project

QUESTION

In a DNP project for deprescribing using the STOPP and START, can you state that the inclusion is all residents 65 years and older who are on five or more medications? Project exclusion criteria or all residents 65 and younger with 5 or fewer medications prescribed.

ANSWER

Optimizing Medication Regimens in Older Adults: A Deprescribing DNP Project

Introduction

Deprescribing, a vital aspect of geriatric care, aims to reduce the burden of polypharmacy and adverse drug events in older adults. The Screening Tool of Older Persons’ Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria are evidence-based tools that guide deprescribing decisions. This essay outlines the inclusion and exclusion criteria for a Doctor of Nursing Practice (DNP) project focused on deprescribing using STOPP and START criteria in residents aged 65 and older who are on five or more medications.

Inclusion Criteria

The DNP project focuses on residents aged 65 and older residing in a specific healthcare setting, such as long-term care facilities or senior living communities. Inclusion criteria for the project encompass the following:

Age: Residents must be 65 years or older, reflecting the geriatric population most susceptible to polypharmacy-related issues.

Medication Burden: Residents included in the project must currently be on five or more medications. This criterion ensures that participants experience a significant medication regimen, making them suitable candidates for deprescribing interventions.

Exclusion Criteria

To maintain the project’s focus and ensure its effectiveness, certain exclusion criteria are established to delineate the target population more precisely:

Age Limitation: Residents aged 65 and younger are excluded from the project. This criterion aligns with the project’s emphasis on the geriatric population, who often face distinct challenges related to polypharmacy and medication management.

Medication Burden: Residents with fewer than five prescribed medications are excluded. This criterion helps to concentrate the intervention’s impact on those with more complex medication regimens, aligning with the project’s deprescribing goals.

Rationale for Criteria

The rationale behind the inclusion and exclusion criteria is multi-faceted and guided by evidence-based practice:

Age Consideration: Older adults are more vulnerable to adverse drug events due to physiological changes and age-related factors. Focusing on residents aged 65 and older aligns with the population at greater risk of medication-related issues.

Medication Burden: Participants taking five or more medications are more likely to experience polypharmacy-related problems, making them suitable candidates for deprescribing interventions. Targeting this specific population allows for a focused approach to medication optimization.

Conclusion

In a DNP project aimed at optimizing medication regimens through deprescribing using STOPP and START criteria, precise inclusion and exclusion criteria are crucial for ensuring the project’s effectiveness. By including residents aged 65 and older who are on five or more medications, the project maximizes its impact on those most susceptible to polypharmacy-related issues. Exclusion criteria further refine the focus, contributing to a well-defined target population and enhancing the project’s outcomes.