Why ScriptSieve exists
Medication reviews matter — polypharmacy is one of the most modifiable risk factors for falls, cognitive decline, hospitalization, and reduced quality of life in older adults. The evidence is there: Beers Criteria, STOPP/START, deprescribing.org. The problem is time.
In a busy clinic, a thorough medication review can take 20–30 minutes of focused attention — time most clinicians simply don't have between patients. The result is that these reviews happen rarely, if at all, even when a patient's medication list quietly accumulates risk over years.
ScriptSieve was built by a family physician who kept running into this problem. The goal is simple: make a guideline-based medication review faster than not doing one. Paste a medication list, get a structured report in seconds. The tool does the cross-referencing; you make the clinical decisions.
What it checks
- Beers Criteria 2023 — American Geriatrics Society list of medications that are potentially inappropriate in older adults (≥65), categorized as Avoid or Use with Caution.
- STOPP v3 — Screening Tool of Older Persons' Prescriptions. European criteria identifying medications where the risk outweighs the benefit in older adults, updated in 2023.
- START v3 — Screening Tool to Alert to Right Treatment. Identifies evidence-based medications that are under-prescribed in older adults with specific conditions.
- deprescribing.org algorithms — Condition-specific tapering and discontinuation protocols from the Canadian deprescribing network.
The drug database covers approximately 175 medications across these frameworks. It is not exhaustive — if a drug isn't flagged, that does not mean it is appropriate. ScriptSieve is a starting point for a conversation, not a complete medication reconciliation.
How to use it
- Paste your patient's medication list — any format works (plain list, EMR history summary, Accuro Copyable History).
- Optionally score frailty with the Edmonton Frail Scale before running the analysis.
- Set patient context: falls risk, renal function, relevant conditions.
- Review the matched medications and confirm or adjust the indication for each.
- Copy the structured report into your chart note or print it for the patient.
Important limitations
ScriptSieve is an educational decision-support tool. It does not constitute medical advice and is not a substitute for clinical judgement. Flagged medications are potentially inappropriate — whether to deprescribe always depends on the individual patient's goals, comorbidities, and preferences.
Criteria are applied based on medication name matching alone. The tool cannot verify dose, duration, indication, or allergy history from the text you enter. Always review flags in the context of the full clinical picture.
No patient data is transmitted or stored. All processing happens in your browser.
Feedback & contributions
Found a drug that should be flagged but isn't? A false positive? A matching bug? Use the report button beside any result, or reach out directly. This tool improves when clinicians who use it tell us what's wrong.