The EU(7)-PIM List: a List of Potentially Inappropriate Medications for Older People Consented by Experts from Seven European Countries

Overview

Journal Eur J Clin Pharmacol

Specialty Pharmacology

Date 2015 May 14

PMID 25967540

Citations 191

Authors

Anna Renom-Guiteras

Gabriele Meyer

Petra A Thurmann

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of the study was to develop a European list of potentially inappropriate medications (PIM) for older people, which can be used for the analysis and comparison of prescribing patterns across European countries and for clinical practice.

Methods: A preliminary PIM list was developed, based on the German PRISCUS list of potentially inappropriate medications and other PIM lists from the USA, Canada and France. Thirty experts on geriatric prescribing from Estonia, Finland, France, the Netherlands, Spain and Sweden participated; eight experts performed a structured expansion of the list, suggesting further medications; twenty-seven experts participated in a two-round Delphi survey assessing the appropriateness of drugs and suggesting dose adjustments and therapeutic alternatives. Finally, twelve experts completed a brief final survey to decide upon issues requiring further consensus.

Results: Experts reached a consensus that 282 chemical substances or drug classes from 34 therapeutic groups are PIM for older people; some PIM are restricted to a certain dose or duration of use. The PIM list contains suggestions for dose adjustments and therapeutic alternatives.

Conclusions: The European Union (EU)(7)-PIM list is a screening tool, developed with participation of experts from seven European countries, that allows identification and comparison of PIM prescribing patterns for older people across European countries. It can also be used as a guide in clinical practice, although it does not substitute the decision-making process of individualised prescribing for older people. Further research is needed to investigate the feasibility and applicability and, finally, the clinical benefits of the newly developed list.

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References

Gallagher P, OMahony D . STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria. Age Ageing. 2008; 37(6):673-9. DOI: 10.1093/ageing/afn197. View

Gallagher P, Ryan C, Byrne S, Kennedy J, OMahony D . STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther. 2008; 46(2):72-83. DOI: 10.5414/cpp46072. View

Spinewine A, Schmader K, Barber N, Hughes C, Lapane K, Swine C . Appropriate prescribing in elderly people: how well can it be measured and optimised?. Lancet. 2007; 370(9582):173-184. DOI: 10.1016/S0140-6736(07)61091-5. View

Laroche M, Charmes J, Merle L . Potentially inappropriate medications in the elderly: a French consensus panel list. Eur J Clin Pharmacol. 2007; 63(8):725-31. DOI: 10.1007/s00228-007-0324-2. View

Jano E, Aparasu R . Healthcare outcomes associated with beers' criteria: a systematic review. Ann Pharmacother. 2007; 41(3):438-47. DOI: 10.1345/aph.1H473. View

Passarelli M, Jacob-Filho W, Figueras A . Adverse drug reactions in an elderly hospitalised population: inappropriate prescription is a leading cause. Drugs Aging. 2005; 22(9):767-77. DOI: 10.2165/00002512-200522090-00005. View

OMahony D, OSullivan D, Byrne S, OConnor M, Ryan C, Gallagher P . STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2014; 44(2):213-8. PMC: 4339726. DOI: 10.1093/ageing/afu145. View

Patterson S, Cadogan C, Kerse N, Cardwell C, Bradley M, Ryan C . Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014; (10):CD008165. DOI: 10.1002/14651858.CD008165.pub3. View

Frankenthal D, Lerman Y, Kalendaryev E, Lerman Y . Intervention with the screening tool of older persons potentially inappropriate prescriptions/screening tool to alert doctors to right treatment criteria in elderly residents of a chronic geriatric facility: a randomized clinical trial. J Am Geriatr Soc. 2014; 62(9):1658-65. DOI: 10.1111/jgs.12993. View

10.

Reich O, Rosemann T, Rapold R, Blozik E, Senn O . Potentially inappropriate medication use in older patients in Swiss managed care plans: prevalence, determinants and association with hospitalization. PLoS One. 2014; 9(8):e105425. PMC: 4138178. DOI: 10.1371/journal.pone.0105425. View

11.

Gosch M, Wortz M, Nicholas J, Doshi H, Kammerlander C, Lechleitner M . Inappropriate prescribing as a predictor for long-term mortality after hip fracture. Gerontology. 2013; 60(2):114-22. DOI: 10.1159/000355327. View

12.

Elseviers M, Vander Stichele R, van Bortel L . Quality of prescribing in Belgian nursing homes: an electronic assessment of the medication chart. Int J Qual Health Care. 2013; 26(1):93-9. DOI: 10.1093/intqhc/mzt089. View

13.

Price S, Holman C, Sanfilippo F, Emery J . Association between potentially inappropriate medications from the Beers criteria and the risk of unplanned hospitalization in elderly patients. Ann Pharmacother. 2014; 48(1):6-16. DOI: 10.1177/1060028013504904. View

14.

Kaufmann C, Tremp R, Hersberger K, Lampert M . Inappropriate prescribing: a systematic overview of published assessment tools. Eur J Clin Pharmacol. 2013; 70(1):1-11. DOI: 10.1007/s00228-013-1575-8. View

15.

Hill-Taylor B, Sketris I, Hayden J, Byrne S, OSullivan D, Christie R . Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact. J Clin Pharm Ther. 2013; 38(5):360-72. DOI: 10.1111/jcpt.12059. View

16.

Montastruc F, Gardette V, Cantet C, Piau A, Lapeyre-Mestre M, Vellas B . Potentially inappropriate medication use among patients with Alzheimer disease in the REAL.FR cohort: be aware of atropinic and benzodiazepine drugs!. Eur J Clin Pharmacol. 2013; 69(8):1589-97. DOI: 10.1007/s00228-013-1506-8. View

17.

Shelton P, Fritsch M, Scott M . Assessing medication appropriateness in the elderly: a review of available measures. Drugs Aging. 2000; 16(6):437-50. DOI: 10.2165/00002512-200016060-00004. View

18.

Campbell S, Cantrill J . Consensus methods in prescribing research. J Clin Pharm Ther. 2001; 26(1):5-14. DOI: 10.1046/j.1365-2710.2001.00331.x. View

19.

Marshall M, Shekelle P, McGlynn E, Campbell S, Brook R, Roland M . Can health care quality indicators be transferred between countries?. Qual Saf Health Care. 2003; 12(1):8-12. PMC: 1743668. DOI: 10.1136/qhc.12.1.8. View

20.

Fick D, Cooper J, Wade W, Waller J, Maclean J, Beers M . Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003; 163(22):2716-24. DOI: 10.1001/archinte.163.22.2716. View