A comparison of two tools to screen potentially inappropriate medication in internal medicine patients

Blanc, Anne-Laure; Spasojević, Slobodan; Leszek, Alexandre; Théodoloz, M.; Bonnabry, Pascal; Fumeaux, Thierry; Schaad, Nicolas

doi:10.1111/jcpt.12638

Cited by 11 publications

(11 citation statements)

References 38 publications

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“…According to our knowledge, this is the first study assessing the concordance and overlap of three distinct PIM-detecting tools EU( 7)-PIM list, 2019 AGS Beers criteria, and STOPP v2 criteria in hospitalized patients. The low overlap and concordance between tools highlight the need to develop a PIM-detecting tool for patients exposed to a high number of PIMs ( ≈ 80%, in all tools used) and reinforce the fact that general internal medicine patients are at risk of PIM (Hudhra et al, 2016;Blanc et al, 2018a;Blanc et al, 2018b). Although being developed for different drug markets and different populations, these criteria are the most used.…”

Section: Discussionmentioning

confidence: 99%

Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

et al. 2021

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Background: Age-related comorbidities prone older adults to polypharmacy and to an increased risk of potentially inappropriate medication (PIM) use. This work aims to analyze the concordance and overlap among the EU(7)-PIM list, 2019 Beers criteria, and Screening Tool of Older Person’s Prescriptions (STOPP) version 2 criteria and also to analyze the prevalence of PIM.Methods: A retrospective cohort study was conducted on older inpatients of an internal medicine ward. Demographic, clinical, and pharmacological data were collected, during March 2020. After PIM identification by the EU(7)-PIM list, Beers criteria, and STOPP v2 criteria, the concordance and overlap between criteria were analyzed. A descriptive analysis was performed, and all the results with a p-value lower than 0.05 were considered statistically significant.Results: A total of 616 older patients were included in the study whose median age was 85 (Q1–Q3) (78–89) years. Most of the older patients were male (51.6%), and the median (Q1–Q3) number of days of hospitalization was 17 (13–22) days. According to the EU(7)-PIM list, Beers criteria, and STOPP criteria, 79.7, 92.0, and 76.5% of older adults, respectively, used at least one PIM. A poor concordance (<63.4%) among criteria was observed. An association between PIM and the number of prescribed medicines was found in all applied criteria. Moreover, an association between the number of PIMs and diagnoses of endocrine, nutritional, and metabolic diseases, mental, behavioral, and neurodevelopmental disorders, and circulatory system diseases and days of hospitalization was observed according to Beers criteria, and that with diseases of the circulatory system and musculoskeletal system and connective tissue was observed according to STOPP criteria.Conclusion: Despite the poor concordance between the EU(7)-PIM list, 2019 Beers, and STOPP v2 criteria, this work highlights the need for more studies in inpatients to develop strategies to facilitate the identification of PIM to decrease the high prevalence of PIM in hospitalized patients. The poor concordance among criteria also highlights the need to develop new tools adapting the existing criteria to medical ward inpatients.

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Section: Discussionmentioning

confidence: 99%

Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

et al. 2021

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“…Eighth, we did not evaluate the preventability of unplanned readmissions. However, a recent study reported that there was no difference in the number of PIMs between hospitalised elderly patients who had experienced an avoidable readmission and those who had not 65. Ninth, an association between disease-specific PIMs66 and unplanned readmissions was not evaluated.…”

Section: Limitationsmentioning

confidence: 99%

Association between potentially inappropriate medications at discharge and unplanned readmissions among hospitalised elderly patients at a single centre in Japan: a prospective observational study

2019

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ObjectiveTo determine the prevalence of potentially inappropriate medication (PIM) use at admission and discharge among hospitalised elderly patients and evaluate the association between PIMs at discharge and unplanned readmission in Japan.DesignA prospective observational study conducted by using electronic medical records.ParticipantsAll consecutive patients aged 65 years or older who were admitted to the internal medicine ward were included. Patients who were electively admitted for diagnostic procedures were excluded.Main outcome measuresThe primary outcome was 30-day unplanned readmissions. The secondary outcome was the prevalence of any PIM use at admission and discharge. PIMs were defined based on the Beers Criteria. The association between any PIM use at discharge and the primary outcome was evaluated by using logistic regression.ResultsSeven hundred thirty-nine eligible patients were included in this study. The median patient age was 82 years (IQR 74–88); 389 (52.6%) were women, and the median Charlson Comorbidity Index was 2 (IQR 0–3). The proportions of patients taking any PIMs at admission and discharge were 47.2% and 32.2%, respectively. Of all the patients, 39 (5.3%) were readmitted within 30 days after discharge for the index hospitalisation. The use of PIMs at discharge was not associated with an increased risk of 30-day readmission (OR 0.93; 95% CI 0.46 to 1.87). This result did not change after adjusting for patient age, sex, number of medications, duration of hospital stay and comorbidities (OR 0.78; 95% CI 0.36 to 1.66).ConclusionThe prevalence of any PIM use at discharge was high among hospitalised elderly patients in a Japanese hospital. Although the use of PIMs at discharge was not associated with an increased risk of unplanned readmission, given a lack of power of this study due to a low event rate, further studies investigating this association are needed.Trial registration numberUMIN000027189.

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“…The first study [21] is the only one performing a comparison between PIM-Check and STOPP/START. In this study, the study population was slightly younger (mean age 77 years), with however 84% of patients aged > 65 years [21], with a mean number of drugs close to our findings (7 drugs per patient). The number of PIP per patient detected by PIM-Check was higher in comparison to our study (6.1 vs 4.2).…”

Section: Discussionmentioning

confidence: 99%

“…PIM-Check was originally designed for patients hospitalized in internal medicine comprising a population with a wider range of age. The current available literature evaluating the use of this tool is composed by three studies [ 21 – 23 ] conducted in internal medicine settings. The first study [ 21 ] is the only one performing a comparison between PIM-Check and STOPP/START.…”

Section: Discussionmentioning

confidence: 99%

Ability to detect potentially inappropriate prescribing in older patients: comparative analysis between PIM-Check and STOPP/STARTv2

Farhat

Panchaud

Al‐Hajje

et al. 2021

Eur J Clin Pharmacol

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Purpose Potentially inappropriate prescribing (PIP) is a source of preventable adverse drug events. The objective of this study was a comparative analysis (quantitative and qualitative) between two tools used to detect PIP, PIM-Check and STOPP/START. Methods First, a qualitative analysis (QAC) was conducted to evaluate the concordance between the criteria, which constitute PIM-Check and the gold standard STOPP/START. Second, a retrospective comparative and observational study was performed on the list of treatment at the admission of 50 older patients hospitalized in an acute geriatric ward of a university hospital in Switzerland in 2016 using both tools. Results The QAC has shown that 50% (57 criteria) of STOPP/START criteria are fully or partially concordant with those of PIM-Check. The retrospective study was performed on 50 patients aged 87 years, suffering from 5 co-morbidities (min–max 1–11) and treated by of 8 drugs (min–max 2–16), as medians. The prevalence of the detected PIP was 80% by PIM-Check and 90% by STOPP/START. Medication review shows that 4.2 PIP per patient were detected by PIM-Check and 3.5 PIP by STOPP/START among which 1.9 PIP was commonly detected by both tools, as means. PIM-Check detected more PIP related to cardiology, angiology, nephrology, and endocrinology in older patients but missed the PIP related to geriatric syndromes (e.g., fall, dementia, Alzheimer) detected by STOPP/START. Conclusions By using PIM-Check in geriatric settings, some PIP will not be detected. It is considered as a limitation for this tool in this frail population but brings a certain complementarity in other areas of therapy not covered by STOPP/START.

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A comparison of two tools to screen potentially inappropriate medication in internal medicine patients

Cited by 11 publications

References 38 publications

Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

Association between potentially inappropriate medications at discharge and unplanned readmissions among hospitalised elderly patients at a single centre in Japan: a prospective observational study

Ability to detect potentially inappropriate prescribing in older patients: comparative analysis between PIM-Check and STOPP/STARTv2

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