Applicability of STOPP/START prescribing criteria in integrated Swedish administrative health registries and a Swedish population-based cohort

This study aimed to assess the applicability of the three available STOPP/START versions in two distinct observational data sources: (i) administrative health registries (ii) population-based cohort study on ageing and care. The first STOPP/START version demonstrated the highest applicability. The population-based cohort study, with its comprehensive clinical assessments, allowed for an enhanced applicability for all three STOPP/START versions. To improve the STOPP/START screening tool in research and facilitate result generalisability and comparability, future versions of the screening tool should strive to provide clear and unambiguous disease and drug definitions, as well as comprehensive indications for the operationalisation of the implicit criteria. The STOPP/START criteria are frequently applied in observational studies to assess potentially inappropriate prescribing in older adults. This study aimed to assess the applicability of the three available STOPP/START versions in two distinct data sources. To evaluate the applicability of the three versions of STOPP/START criteria, we used two observational data sources: (i) Integrated Swedish administrative health registries (ISHR) encompassing routinely collected health data and (ii) the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K), based on health professional-led clinical assessments. The Anatomical Therapeutic Classification code (ATC) was used to categorise medications. Diseases were categorised using the international classification of diseases version 10 (ICD10). The first STOPP/START version demonstrated an applicability rate of 80