Table 4 Descriptions of potentially inappropriate medications as per STOPP criteria (n = 121)

Cardiovascular System

B05. Beta-blocker as monotherapy for uncomplicated hypertension i.e., not associated with angina pectoris, aortic aneurysm or other condition where beta-blocker therapy is indicated (no firm evidence of efficacy)

4

3.3

B07. Loop diuretic as first-line treatment for hypertension unless there is concurrent heart failure requiring diuretic therapy (safer, more effective alternatives available)

7

5.8

B08. Loop diuretic for dependent ankle edema without clinical, biochemical or radiological evidence of heart failure, liver failure, nephrotic syndrome or renal failure (leg elevation and /or compression hosiery usually more appropriate)

3

2.5

B13. Aldosterone antagonists (e.g., spironolactone, eplerenone) with concurrent potassium-conserving drugs (e.g., ACEI’s, ARB’s, amiloride, triamterene) without monitoring of serum potassium (risk of dangerous hyperkalaemia i.e., > 6.0 mmol/l-serum K should be monitored regularly, i.e., at least every 6 months)

19

15.7

Central Nervous System

D24. First-generation antihistamines as first line treatment for allergy or pruritis (safer, less toxic antihistamines with fewer side effects now widely available)

17

14.0

Renal System

E01. Digoxin at a long-term (i.e. more than 90 days) maintenance dose ≥ 125 μg/day if eGFR < 30 ml/min/1.73m2 (risk of digoxin toxicity if plasma levels not measured)

1

0.8

Musculoskeletal System

H05. Corticosteroids (other than periodic intra-articular injections for mono-articular pain) for osteoarthritis (risk of systemic corticosteroid side-effects)

6

5.0

Endocrine System

J01. Sulphonylureas with a long half-life (e.g., glibenclamide, chlorpropamide, glimepiride) with type 2 diabetes mellitus (risk of prolonged hypoglycaemia)

63

52.1

Antimuscarinic/Anticholinergic Drug Burden

M01. Concomitant use of two or more drugs with antimuscarinic/anticholinergic properties (e.g., bladder antispasmodics, intestinal antispasmodics, tricyclic antidepressants, first generation antihistamines, antipsychotics) (risk of increased antimuscarinic/anticholinergic toxicity)

1

0.8