Beers, STOPP/START, and PRISCUS: A critical analysis of their evolution and applicability in geriatrics prescribing.

Abstract

Introduction: Polypharmacy, defined as the concomitant use of five or more medications, is common in older adults. Potentially inappropriate medications (PIMs) are drugs whose risks outweigh their potential benefits in older adults, especially when other effective alternatives are available. The objective of this research is to conduct a comparative analysis of the evolution, cross-cultural adaptations, advantages, and limitations of the Beers, STOPP/START, and PRISCUS criteria to evaluate their applicability in diverse clinical contexts.Method: A critical narrative review of articles retrieved from the PubMed, LILACS, SciELO, and Cochrane databases. The search was limited to the period between 2014 and 2024, with no initial language restrictions applied. Original articles, systematic reviews, clinical practice guidelines, and validation studies were included.Results: Out of the 675 references retrieved, 31 articles were selected after applying the inclusion and exclusion criteria. The Beers criteria accounted for 73.7 % of the total identified publications (n=498/675), and the 11 adaptations of the STOPP/START criteria were noteworthy.Conclusions: The Beers and STOPP/START criteria have transcended their original purpose to become foundational pillars for the development of local tools. Their value lies not only in their direct application but also in their role as reference frameworks for the creation and validation of culturally adapted criteria.