Abstract：
OBJECTIVE: To adapt the 2015 Screening Tool of Older Persons\' Prescriptions (STOPP)/Screening Tool to Alert to Right Treatment (START) criteria to older nursing home patients with a limited life expectancy of 1.5 to 2 years.
METHODS: A modified Delphi consensus study.
METHODS: The study was established in The Netherlands and conducted online. The international panel consisted of 23 experts with experience in medicine for older people.
METHODS: The expert panel was presented with the 2015 STOPP/START criteria using an online survey program (Survey Monkey). The panelists were asked for their opinion on the appropriateness of the STOPP and START criteria, and adaptations to these criteria for older nursing home patients with a limited life expectancy on 4-point Likert scales. Consensus was defined as ≥70% of the panelists answering (very) inappropriate or (very) appropriate, and (completely) disagree or (completely) agree.
RESULTS: Twenty-one panelists completed all 3 Delphi rounds. The final list of \"Represcribing for Nursing home residents With A Limited life expectancy (ReNeWAL)\" criteria comprises 132 criteria: 98 criteria to stop (70 original STOPP criteria and 28 adapted) and 34 criteria to start (16 original START criteria and 18 adapted) for older nursing home patients with a limited life expectancy. Considerations that panelists mentioned for adapting criteria were mainly prevention and treatment of discomfort.
CONCLUSIONS: It is clear that represcribing for older nursing home patients is highly complex and requires the consideration of various elements. The ReNeWAL criteria may be useful in enhancing represcribing for older nursing home patients with a limited life expectancy.
METHODS: A modified Delphi consensus study.
METHODS: The study was established in The Netherlands and conducted online. The international panel consisted of 23 experts with experience in medicine for older people.
METHODS: The expert panel was presented with the 2015 STOPP/START criteria using an online survey program (Survey Monkey). The panelists were asked for their opinion on the appropriateness of the STOPP and START criteria, and adaptations to these criteria for older nursing home patients with a limited life expectancy on 4-point Likert scales. Consensus was defined as ≥70% of the panelists answering (very) inappropriate or (very) appropriate, and (completely) disagree or (completely) agree.
RESULTS: Twenty-one panelists completed all 3 Delphi rounds. The final list of \"Represcribing for Nursing home residents With A Limited life expectancy (ReNeWAL)\" criteria comprises 132 criteria: 98 criteria to stop (70 original STOPP criteria and 28 adapted) and 34 criteria to start (16 original START criteria and 18 adapted) for older nursing home patients with a limited life expectancy. Considerations that panelists mentioned for adapting criteria were mainly prevention and treatment of discomfort.
CONCLUSIONS: It is clear that represcribing for older nursing home patients is highly complex and requires the consideration of various elements. The ReNeWAL criteria may be useful in enhancing represcribing for older nursing home patients with a limited life expectancy.
摘要：
目的：使2015年老年人处方筛查工具（STOPP）/筛查工具适应预期寿命为1.5至2年的老年疗养院患者的正确治疗（START）标准。
方法：改良的德尔菲共识研究。
方法：该研究在荷兰建立并在线进行。国际小组由23名具有老年人医学经验的专家组成。
方法：使用在线调查程序（调查猴子）向专家小组介绍了2015STOPP/START标准。小组成员被要求就STOPP和START标准的适当性发表意见，以及在4分Likert量表上，预期寿命有限的老年疗养院患者对这些标准的适应。共识被定义为≥70％的小组成员回答（非常）不适当或（非常）适当，并且（完全）不同意或（完全）同意。
结果：21名小组成员完成了所有3轮Delphi。“预期寿命有限的疗养院居民的代表性（ReNeWAL）”标准的最终列表包括132个标准：98个标准停止（70个原始STOPP标准和28个适应）和34个标准开始（16个原始START标准和18个适应）用于预期寿命有限的老年疗养院患者。小组成员提到的适应标准的考虑主要是预防和治疗不适。
结论：很明显，老年疗养院患者的治疗非常复杂，需要考虑各种因素。ReNeWAL标准可能有助于增强预期寿命有限的老年疗养院患者的治疗效果。
方法：改良的德尔菲共识研究。
方法：该研究在荷兰建立并在线进行。国际小组由23名具有老年人医学经验的专家组成。
方法：使用在线调查程序（调查猴子）向专家小组介绍了2015STOPP/START标准。小组成员被要求就STOPP和START标准的适当性发表意见，以及在4分Likert量表上，预期寿命有限的老年疗养院患者对这些标准的适应。共识被定义为≥70％的小组成员回答（非常）不适当或（非常）适当，并且（完全）不同意或（完全）同意。
结果：21名小组成员完成了所有3轮Delphi。“预期寿命有限的疗养院居民的代表性（ReNeWAL）”标准的最终列表包括132个标准：98个标准停止（70个原始STOPP标准和28个适应）和34个标准开始（16个原始START标准和18个适应）用于预期寿命有限的老年疗养院患者。小组成员提到的适应标准的考虑主要是预防和治疗不适。
结论：很明显，老年疗养院患者的治疗非常复杂，需要考虑各种因素。ReNeWAL标准可能有助于增强预期寿命有限的老年疗养院患者的治疗效果。
