START (screening tool to alert doctors to the right treatment)

Contact information:  

gespag, Austria
Tilman Königswieser, [email protected]

Originally developed by: Cork University Hospital
Country of origin: Ireland
Year of development: 2007
Last updated: No information available
Next update: No information available
Available in the following languages: English

Type of tool: tool for reminding staff in the workplace

Short description

Approximately one in three older persons taking more than 4 medications (=polypharmacy) will experience an adverse drug reaction in the following year. Tools in polypharmacy are needed as  practical guides for clinical practice or for the geriatric ward to solve the problem. START is a screening tool to alert doctors to the right treatment.  START incorporates 22 evidence-based indicators for prescribing omissions in older people. The use of the START tool identified that approximately 57% of older adults admitted to a teaching hospital had at least one appropriate medication omitted.

Target audience

Medical staff

Applicability (setting e.g. inpatient care, outpatient care, long term care etc.)

Inpatient care, outpatient care, long term care

Information on how the tool has been applied/tested in practice

We have started to use this tool in one of our hospitals as a part of a programme called ACADEMIA (assess, comprehensive geriatric assessment, adherence, development, emergence, minimization, interdisciplinarity, alertness) in order to improve medication lists of geriatric patients suffering from polypharmacy. In our opinion it is easy to handle and a useful tool for clinicans.

Needed resources (financial, material, human)

Time to use it, costs are negligible

Needed time for implementation

One month in a department

Strengths and limitations

Only one part in the puzzle of improving medication lists, to be successful in improving patient medication lists you have to put  it in a conceptional framework like our programme ACADEMIA.