Objective To validate STOPPCog, a list of explicit criteria for potentially inappropriate medication use in cognitively vulnerable older adults. Design A Delphi consensus survey of an expert panel comprising academic geriatricians, old age psychiatrists, general practitioners, and clinical pharmacists. Setting Ireland. Subjects Nine panellists. Methods STOPPCog criteria were initially created by the authors based on clinical experience and literature appraisal. Criteria were organised according to drug/drug class. Using Delphi consensus methodology, panellists ranked their agreement with each criterion on a 5-point Likert scale and provided written feedback. Criteria with a median value of 1 or 2 (strongly agree/agree) and a 25th centile value of ≤2 were included in the final list. Results All panellists completed two Delphi consensus validation rounds. Twenty-five criteria were proposed initially, twenty were accepted. One criterion was rejected (multi-vitamin supplements), and four criteria were rephrased (two of these were combined to one criterion for greater clarity). The final list comprised 23 criteria that are arranged in six subgroups i.e. (i) drugs with anticholinergic properties taken daily; (ii) drugs with sedative properties taken daily; (iii) drugs that may exacerbate psychotic symptoms in patients with alpha-synuclein pathology; (iv) drugs used for chronic pain; (v) drugs without proven efficacy for dementia taken daily; (vi) drugs that are of no proven benefit in advanced stage dementia i.e. clinical dementia rating of 3.0 where palliation may be appropriate. Conclusion STOPPCog comprises 23 criteria relating to medications that are potentially inappropriate in cognitively vulnerable older adults. STOPPCog may assist physicians in deprescribing medications in this patient population.

中文翻译：

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在认知脆弱的老年人中弃用：STOPPCog 标准的开发和验证


目的 验证 STOPPCog，这是认知脆弱的老年人可能不适当使用药物的明确标准列表。设计 由学术老年病学家、老年精神病学家、全科医生和临床药剂师组成的专家小组的 Delphi 共识调查。设置 Ireland。主题 9 名小组成员。方法 STOPPCog 标准最初由作者根据临床经验和文献评价制定。标准根据药物/药物类别进行组织。使用 Delphi 共识方法，小组成员在 5 点李克特量表上对他们对每个标准的同意程度进行排名，并提供书面反馈。最终列表中包括中位数值为 1 或 2（非常同意/同意）且第 25 个百分位数值为 ≤2 的标准。结果 所有小组成员都完成了两轮 Delphi 共识验证。最初提出了 25 项标准，其中 20 项被接受。一项标准被拒绝（多种维生素补充剂），并改写了四项标准（其中两项合并为一项标准以提高清晰度）。最终列表包括 23 项标准，分为六个子组，即 （i） 每天服用具有抗胆碱能特性的药物;（ii） 每天服用具有镇静作用的药物;（iii） 可能加剧 α-突触核蛋白病理患者精神病症状的药物;（iv） 用于治疗慢性疼痛的药物;（v） 每天服用对痴呆没有证实疗效的药物;（vi） 未证实对晚期痴呆有益的药物，即临床痴呆评分为 3.0，在可能适合姑息的情况下。结论 STOPPCog 包括 23 项与可能不适合认知脆弱老年人的药物相关的标准。 STOPPCog 可以帮助医生在该患者群体中取消开药。