Potentially inappropriate medication in acute hospitalized elderly patients with polypharmacy: an observational study comparing PRISCUS, STOPP, and Beers criteria

Sierra, Lorena; Salazar, J. Rodríguez; Jiménez-Muñoz, Ana Belén; Hernández, M.J. Molina; Bescós, Paloma Bermejo; Peinado, Irene Iglesias; Díaz, Benito García

doi:10.1007/s00228-020-03022-8

Cited by 13 publications

(8 citation statements)

References 34 publications

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“…In this respect, our study can be considered the first to our knowledge. Similar to our study, 65.2% of PIM patients evaluated with STOPP criteria were found in the study conducted by de Agustín Sierra et al 3 in Spain at the age of 80 years and above. In the study conducted by van Loveren et al 6 in 2019 in 150 patients diagnosed with cancer aged 65 years and older in the Netherlands, PIM was detected in 49% of patients using the STOPP criteria.…”

Section: Discussionsupporting

confidence: 91%

“…To this end, a clear medication list is a crucial step. The correct medication list should include matching the diagnosis to the prescription, selecting the most appropriate medication, educating the patient and carer about the patient’s physiological responses, and ensuring that the medication is used as directed 3 . Another critical issue with medication among older adults is the prescription and use of PIM 4 .…”

Section: Introductionmentioning

confidence: 99%

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Effects of Potentially Inappropriate Medications in Older Patients with Gastrointestinal System Cancer

OZKAN,

KARAHAN,

YALCIN

et al. 2023

MMJ

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Objective: Potentially inappropriate medications (PIM) is a crucial problem in the geriatric population. The amount of prescription and unadherence increase because of the different problems encountered in cancer patients. Our aim was to evaluate the effects of PIM in patients with gastrointestinal system cancer and to investigate its relationship with chemotherapy side effects, mortality, and progression. Methods: This retrospective cohort study assessed 154 patients with gastrointestinal system cancer. Demographics and disease features, the presence of PIM according to the “TIME-to-STOP” criteria and baseline laboratory parameters were recorded. The effects of PIM on survival and adverse treatment events were evaluated. Results: 66.9% of the cases were male and 33.1% were female. The mean age was 71.9±6.4 years. The most common side effects of chemotherapy are nausea, vomiting, kidney injury, and pain. The most frequently used prescriptions among the 98 PIMs were gliclazide, hyoscine N-butylbromide, simethicone, diphenoxylate atropine, and thiocolchicoside. PIM was detected in 68.1% of the participants. Chemotherapy side effects were more common in PIM group (p<0.001, odds ratio =5.6). PIM had no effect on mortality. Factors associated with mortality were age, stage, albumin, creatinine, operation history, and progression. A significant relationship was found between age, cancer stage, albumin, creatinine, operation history, and PIM in the regression model. There was no relationship between PIM and progression-free survival. Conclusion: Chemotherapy toxicity may increase with PIM detected on diagnosis. We suggest that PIM is an important factor in predicting the side effects of chemotherapy and minimizing the adverse effects.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Effects of Potentially Inappropriate Medications in Older Patients with Gastrointestinal System Cancer

OZKAN,

KARAHAN,

YALCIN

et al. 2023

MMJ

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“…Several studies have reported the association of polypharmacy with a greater likelihood of inappropriate drug use, adverse drug reactions, hospitalizations, admissions to emergency services, mortality, and other negative health outcomes 20 , 21 , 22 , 23 , 24 . However, in this study, the use of the PIM list to review the pharmacotherapy of polymedicated older adults, followed by general practitioners in PHC, was not associated with improvement in clinical outcomes such as hospitalizations, major geriatric syndromes, death, and quality of life.…”

Section: Discussionmentioning

confidence: 99%

Lists of potentially inappropriate medications for older people in primary care: a systematic review of health outcomes

Rodrigues,

Gomes,

Sodré

et al. 2024

Cad. Saúde Pública

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This study is a systematic literature review of the association between lists of potentially inappropriate medications (PIM) in clinical practice and health outcomes of older adults followed up in primary health care. For this purpose, the PRISMA protocol was used to systematize the search for articles in the PubMed, Web of Science, Scopus, Cochrane Central, LIVIVO and LILACS databases, in addition to the gray literature. Studies with randomized clinical trials were selected, using explicit criteria (lists) for the identification and management of PIM in prescriptions of older patients in primary care. Of the 2,400 articles found, six were used for data extraction. The interventions resulted in significant reductions in the number of PIM and adverse drug events and, consequently, in potentially inappropriate prescriptions (PIP) in polymedicated older adults. However, there were no significant effects of the interventions on negative clinical outcomes, such as emergency room visits, hospitalizations and death, or on improving the health status of the older adults. The use of PIM lists promotes adequate medication prescriptions for older adults in primary health care, but further studies are needed to determine the impact of reducing PIM on primary clinical outcomes.

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“…The frequency and characteristics of PIM prescriptions in the elderly general population have been studied extensively in the past (de Agustín Sierra et al 2021 ; Lohman et al 2017 ; Price et al 2014 ), and it has consistently been demonstrated that a significant proportion of geriatric patients receive PIMs (de Agustín Sierra et al 2021 ; Lohman et al 2017 ). The proportion of patients affected by PIM prescriptions varied substantially between 20 and 60% (de Agustín Sierra et al 2021 ; Lohman et al 2017 ), presumably owing to different study designs and settings. In the context of geriatric psychiatry, there are also several studies that have investigated the frequency and risk factors for PIM prescriptions (Hefner et al 2021 ; Moebs et al 2020 ; Seifert et al 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…In Germany, the PRISCUS list and the Fit fOR The Aged (FORTA) classification are preferred to Beers criteria as they are specifically tailored to the German pharmaceutical market (Pazan et al 2022 ; Siebert et al 2013 ). While the PRISCUS list has repeatedly been evaluated in the clinical setting and its importance in preventing ADRs has been assessed, the utility and importance of the FORTA classification have much less intensely been studied in practice (de Agustín Sierra et al 2021 ; Schubert et al 2013 ). Since psychotropic drugs represent the largest group among PIMs according to both the PRISCUS list and the FORTA classification, an increased incidence of PIM prescriptions can be assumed on gerontopsychiatric wards.…”

Section: Introductionmentioning

confidence: 99%

Potentially inappropriate medications according to PRISCUS list and FORTA (Fit fOR The Aged) classification in geriatric psychiatry: a cross-sectional study

et al. 2022

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Adverse drug reactions (ADRs) constitute a frequent cause of hospitalization in older people. The risk of ADRs is increased by the prescription of potentially inappropriate medications for older people (PIMs). The PRISCUS list and the FORTA classification represent established tools to detect PIMs. The aim of the present study was to examine the prevalence and characteristics of PIM prescriptions on the gerontopsychiatric ward of a university hospital in Germany. To this aim, medication charts of 92 patients (mean age 75.9 ± 7.7 years; 66.3% female) were analyzed on a weekly basis until patient discharge by utilization of the PRISCUS list and the FORTA classification. Overall, 335 medication reviews comprising 2363 drug prescriptions were analyzed. 3.0% of the prescribed drugs were PIMs according to the PRISCUS list, with benzodiazepines and Z-drugs accounting for nearly half (49.3%) of all PIM prescriptions. 30.4% of the patients were prescribed at least one PRISCUS-PIM, while 43.5% of the study population took at least one FORTA class D drug. A considerable proportion of gerontopsychiatric patients were affected by PIMs; however, the overall number of PIM prescriptions in the study population was low. Further improvements in the quality of prescribing should target the use of sedating agents such as benzodiazepines and Z-drugs. Physicians should be aware of discrepancies between the PRISCUS list and the FORTA classification.

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Potentially inappropriate medication in acute hospitalized elderly patients with polypharmacy: an observational study comparing PRISCUS, STOPP, and Beers criteria

Cited by 13 publications

References 34 publications

Effects of Potentially Inappropriate Medications in Older Patients with Gastrointestinal System Cancer

Effects of Potentially Inappropriate Medications in Older Patients with Gastrointestinal System Cancer

Lists of potentially inappropriate medications for older people in primary care: a systematic review of health outcomes

Potentially inappropriate medications according to PRISCUS list and FORTA (Fit fOR The Aged) classification in geriatric psychiatry: a cross-sectional study

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