Prescribing potentially inappropriate medication (PIM) in Germany's elderly as indicated by the PRISCUS list. An analysis based on regional claims data

Schubert, Ingrid; Küpper-Nybelen, J.; Ihle, Peter; Thürmann, Petra A.

doi:10.1002/pds.3429

Cited by 72 publications

(77 citation statements)

References 49 publications

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“…We prepared a preliminary PIM list which contained 85 PIM (82 active substances plus one combination of active substances and two different preparations of one substance) from the German PRISCUS list [22] and 99 PIM from the French [3], American [24, 25] and Canadian [26] lists. These tools have been used in research to evaluate the prescription of PIM and factors associated with PIM use [5, 6, 14, 27–29]. The main reason for each drug being PIM was formulated using the information provided by the original lists.…”

Section: Methodsmentioning

confidence: 99%

The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries

Renom‐Guiteras

Meyer

Thürmann

2015

Eur J Clin Pharmacol

366

399

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PurposeThe 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.MethodsA 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.ResultsExperts 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.ConclusionsThe 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.Electronic supplementary materialThe online version of this article (doi:10.1007/s00228-015-1860-9) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries

Renom‐Guiteras

Meyer

Thürmann

2015

Eur J Clin Pharmacol

366

399

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“…Numerous studies have been conducted in patients with HTN aged over 65 years [19][20][21][22] regarding antihypertensive treatment adherence and antihypertensive drugs associated with cardiovascular conditions [Study on Cognition and Prognosis in the Elderly (SCOPE), Systolic Hypertension in China (SysTChina), the Coope and Warrender study, Systolic Hypertension in the Elderly Program (SHEP)] [1]. However, little data are available for patients aged 75 years and older regarding key geriatric aspects of fragility (delirium, falls, constipation, etc.)…”

Section: Introductionmentioning

confidence: 99%

Potentially Inappropriate Antihypertensive Prescriptions to Elderly Patients: Results of a Prospective, Observational Study

et al. 2017

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“…Whilst most of these tools have defined elderly as those aged 65 years and above, the IPET and the MAI do not provide any specific definition of 'elderly'. A major limitation of some tools is their potential lack of relevance to other countries (different from their origin), since the listed medications may not be available for use (Schubert et al, 2013). For example, Beers' criteria was modified to generate its country-specific versions, for example, the PRISCUS list-Germany (Holt et al, 2010) and the French consensus panel list-France (Laroche et al, 2007).…”

Section: Age-associated Physiological Alterations (Physiological Age)mentioning

confidence: 99%

Pharmacotherapy in the ageing patient: The impact of age per se (A review)

Singh

Bajorek

2015

Ageing Research Reviews

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A literature search was carried out to review the influence of 'ageing' on pharmacotherapeutic decision-making, specifically how 'age' is defined and considered in the utilisation of medication. Embase, Medline, International Pharmaceutical Abstracts, and Google scholar were canvassed in a three-tiered search according to pre-established inclusion criteria. In tier 1, a total of 22 studies were identified highlighting the underutilisation of medication in elderly patients, with a particular focus on warfarin. Four studies highlighted an age-bias in medication-prescribing for elderly patients, specifically in relation to medicines for rheumatoid arthritis, angina, and hypertension. Tier 2 identified diverse definitions for 'elderly', including biological age, chronological age, physiological age, as well as various descriptions of 'elderly' in clinical trials and guidelines. Finally, medication optimisation tools were identified through the third tier, emphasising the use of chronological age to describe the 'elderly'. Old age influences pharmacotherapeutic decision-making at various levels, however, what complicates the situation is the absence of a comprehensive definition of 'elderly'. Clinical recommendations need to be based more on objective factors known to affect medication effectiveness and safety.

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Prescribing potentially inappropriate medication (PIM) in Germany's elderly as indicated by the PRISCUS list. An analysis based on regional claims data

Abstract: PRISCUS-PIMs are widely used. Educational programs should focus on drugs with high treatment prevalence and call professionals' attention to those elderly patients who are at special risk for inappropriate medication.

Cited by 72 publications

References 49 publications

The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries

The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries

Potentially Inappropriate Antihypertensive Prescriptions to Elderly Patients: Results of a Prospective, Observational Study

Pharmacotherapy in the ageing patient: The impact of age per se (A review)

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