Prevalence of potentially inappropriate medication use in older population: comparison of the Finnish Meds75+ database with eight published criteria

Abstract

Background There are several national and international criteria available for identifying potentially inappropriate medications (PIMs) for older people. The prevalence of PIM use may vary depending on the criteria used. The aim is to examine the prevalence of potentially inappropriate medication use in Finland according to the Meds75+ database, developed to support clinical decision-making in Finland, and to compare it with eight other PIM criteria. Methods This nationwide register study consisted of Finnish people aged 75 years or older (n = 497,663) who during 2017–2019 purchased at least one prescribed medicine considered as a PIM, based on any of the included criteria. The data on purchased prescription medicines was collected from the Prescription Centre of Finland. Results The annual prevalence of 10.7–57.0% was observed for PIM use depending on which criteria was used. The highest prevalence was detected with the Beers and lowest with the Laroche criteria. According to the Meds75+ database, annually every third person had used PIMs. Regardless of the applied criteria, the prevalence of PIM use decreased during the follow-up. The differences in the prevalence of medicine classes of PIMs explain the variance of the overall prevalence between the criteria, but they identify the most commonly used PIMs quite similarly. Conclusion PIM use is common among older people in Finland according to the national Meds75+ database, but the prevalence is dependent on the applied criteria. The results indicate that different PIM criteria emphasize different medicine classes, and clinicians should consider this issue when applying PIM criteria in their daily practice.

Impact of the publication of the Finnish Meds75+ database on the use of potentially inappropriate medications in older persons

“…However, according to a recently published study the overlap between the Meds75+ database and eight other PIM criteria varied from 56.9% to 99.1%. 36 Fourth, the intervention was non-mandatory and thus not so effective on changing prescribing practices than mandatory strategies, which had greater evidence of impact on drug use. 37 Fifth, the Prescription Register does not include nursing home residents, therefore the overall PIM prevalence and the average age of the study population would have been higher if they had been included in the study population.…”