Geriatric Medication Management Using STOPP/START Criteria on Polypharmacy in a Multicentre Hospital: A Systematic Review

Background: Patients 65 years of age and above are known as a special risk group for drug prescribing. They face high challenges like multi-comorbidities, polypharmacy, Potentially Inappropriate Prescribing, and the increasing risk of adverse drug reactions. The Screening Tool to Alert Doctors to the Right Treatment (START) and the Screening Tool for Older Persons's Prescriptions (STOPP) criteria are widely used to detect Potentially Inappropriate Prescribing (PIM) and prescribing omissions despite their effectiveness this tool is not widely explored. This systematic review aims to assess the prevalence of PIP, prescribing errors, and the impact of START/STOPP criteria interventions on clinical outcomes in older adults.  Methods: From January 2015 to January 2025, a systematic search was conducted in PubMed, Google Scholar, Cochrane Library, and Scopus. Cross-sectional, Observational, Cohort, and Randomized controlled trials studies involving patients aged 65 and above were included. The data extraction followed PRISMA guidelines. The outcomes included PIP prevalence, types of prescribing errors, and hospitalizations.  Results: A total of 36 articles were assessed, and the total number sample size of 4,449 patients’ data was evaluated through the analysis of 9 studies of the latest years. The potentially inappropriate medication prevalence ranged from 19% to 85.1% of both the national and international reports. The potential prescribing omissions were observed in 4.2% to 81.4% of cases, mostly in hospital settings.  Conclusion: This systematic review highlights the high prevalence of PIP among older adults and the effectiveness of interventions guided by STAT/STOPP criteria. A multidisciplinary approach among healthcare providers is necessary to obtain medication optimization. To achieve future goals the integration of STOPP/START criteria with the integration of electronic prescription systems can automate medication reviews and reduce errors.