Prescribing of Potentially Inappropriate Medications for the Elderly

Amann, Ute; Schmedt, Niklas; Garbe, Edeltraut

doi:10.3238/arztebl.2012.0069

Cited by 64 publications

(79 citation statements)

References 19 publications

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“…Amitriptyline, the most frequent active agent in our analysis (14% of all PIM), is often used to treat neuropathic pain and is inexpensive. This might explain why amitriptyline was the most frequently prescribed PIM in most studies using the Priscus in Germany [14, 45]. However, none of the study participants using amitriptyline in our analysis had a diagnosis of neuropathic pain by their treating GP in their medical records.…”

Section: Discussionmentioning

confidence: 94%

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Wucherer

Eichler

Hertel

et al. 2016

JAD

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Background: Potentially inappropriate medication (PIM) in older people is a risk factor for adverse drug effects. This risk is even higher in older people with dementia (PWD).Objective: Our study aimed to determine (1) the prevalence of PIM among primary care patients who were screened positive for dementia and (2) the sociodemographic and clinical variables associated with the use of PIM.Methods: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg–Western Pomerania) is a general practitioner-based, cluster-randomized, controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in Germany. The comprehensive baseline assessment includes a home medication review. The present analyses are based on the data from 448 study participants (age 70+, DemTect <9). PIMs were identified using the list of Potentially Inappropriate Medications in the Elderly (Priscus).Results: (1) A total of 99 study participants (22%) received at least one PIM. The highest prevalence was found for antidepressants, benzodiazepines, and analgetics. The most frequently prescribed PIMs were amitriptyline, etoricoxib, and doxazosin. (2) Use of a PIM was significantly associated with a diagnosis of a mental or behavioral disorder.Conclusions: The prescription rate of PIMs for community-dwelling PWD was comparable with the rates found for the general population of older people in Germany (20–29%). Antidepressants with anticholinergic properties and long-acting benzodiazepines were the most prescribed PIMs, despite having an unfavorable benefit-risk ratio. This high prevalence of PIM prescriptions in a vulnerable population of PWD indicates that standard care for dementia should include careful medication review and management.

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Section: Discussionmentioning

confidence: 94%

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Wucherer

Eichler

Hertel

et al. 2016

JAD

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“…3 As the age of the patient increases the number of comorbidities increases and also the chance of polypharmacy. 4 Older patients take three times more number of medications as compared to younger patients because of the chronic problems. 5 Geriatric health care professionals rely heavily on pharmacotherapy as palliative cure for symptoms, and to improve the functional status and quality of life of elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Drug prescribing patterns in elderly patients in a tertiary level hospital

Bhaveshaikh

Sukumaran

Vyas

2017

Int J Basic Clin Pharmacol

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Background: Elderly people have multiple co morbidities and are often prescribed potentially inappropriate medications (PIMs). As there is paucity of information about the prescribing practices in elderly this study was undertaken to assess drug utilization patterns in elderly patients.Methods: A prospective observational study was conducted in a tertiary care hospital. A total of 576 prescriptions of elderly patients were included in the study. Prescribing patterns among elderly patients attending OPD and admitted to wards of departments of Medicine, Psychiatry, Dermatology, Pulmonary Medicine, General Surgery, E.N.T., Ophthalmology, Orthopaedics, Obstetrics and Gynaecology were analysed using the prescribing indicators (WHO criteria). The PIMs were identified as per the Beers 2012 criteria.Results: The average number of drugs per patient was 3.91±1.93 for O.P.D and 7.37 ±2.22 for I.P.D. patients. 37.76% patients in I.P.D. and 26.87% patients in O.P.D. received a medication which was potentially inappropriate as per Beers 2012 criteria. 7.58% (234/3088) of total medications prescribed to patients in the study were potentially inappropriate. There was a significant increase in the number of PIMs (p value ˂0.05) as the total number of drugs prescribed increased.Conclusions: Educational programmes are needed to reinforce rational prescribing by physicians and precautions should be taken while prescribing potentially inappropriate drugs to elderly patients.

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“…Of the articles manually assessed, 62 did not meet the inclusion criteria. At the end of the selection process, only 119 articles met the specific inclusion criteria …”

Section: Resultsmentioning

confidence: 99%

Conceptualizing and measuring potentially inappropriate drug therapy

et al. 2015

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Summary What is known and objective Elderly people are the principal consumers of prescription drugs. The more the medication used by the patient, the greater the likelihood there is of the patient being subjected to potentially inappropriate drug therapy (PIDT). PIDT has been measured in the literature with both implicit and explicit tools. The purpose of this review was to assess the use of tools to detect PIDT in various studies and to determine which terms are used to refer to PIDT in practice. Methods A systematic review was conducted according to the following steps: the first was identification. In this step, studies were selected from different combinations of the descriptors ‘aged’, ‘elderly’, ‘inappropriate prescribing’ and ‘drug utilization’ in three different languages, using the Embase, Medline, Scielo, Scopus and Web of Science databases. Second, the papers that satisfied the inclusion criteria for data extraction were carefully examined by three evaluators to determine the tools used and terms that referred to PIDT. Results and discussion From the combinations of keywords, 8610 articles were found. At the end of the selection process, 119 of the articles complied with the specified criteria. The degree of agreement among evaluators was moderate for the study titles (κ1 = 0·479) and substantial for abstracts (κ2 = 0·647). With respect to the PIDT evaluation criteria used by the studies, 27·7% used two criteria. Of the 27 evaluation criteria identified, the Beers criteria were used by 82·3% of the studies. More than 50 different terms to identify PIDT were found in the literature. What is new and conclusion This review is the first study to conceptualize and discuss terms that refer to PIDT. At present, there is no consensus regarding terms used to refer to PIDT, with over 50 different terms currently in use. This review shows an increase in the number of articles aimed at evaluating PIDT using implicit and explicit tools.

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Prescribing of Potentially Inappropriate Medications for the Elderly

Cited by 64 publications

References 19 publications

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Potentially Inappropriate Medication in Community-Dwelling Primary Care Patients who were Screened Positive for Dementia

Drug prescribing patterns in elderly patients in a tertiary level hospital

Conceptualizing and measuring potentially inappropriate drug therapy

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