REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria

Roux, Barbara; Berthou-Contreras, Julie; Beuscart, Jean‐Baptiste; Charenton-Blavignac, Marion; Doucet, J.; Fournier, Jean‐Pascal; Gastine, B. de la; Gautier, Sophie; Gonthier, R.; Gras, Valérie; Grau, Muriel; Noïze, Pernelle; Polard, Élisabeth; Rudelle, Karen; Valnet-Rabier, Marie-Blanche; Tannou, Thomas; Laroche, Marie-Laure

doi:10.1007/s00228-021-03145-6

Cited by 20 publications

(9 citation statements)

References 58 publications

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“…We conducted a longitudinal study on patients aged 75–110 years old, diagnosed with atrial fibrillation, and initiating an OAC treatment (no dispensing in the previous 2 years), either vitamin-K antagonist (VKA) or direct oral anticoagulant (DOAC), between April 2012 and 2016 (inclusion date). The 75-year threshold used to define our study population was defined in line with previous studies and recommendations concerning medication use in older people in France [ 32 – 34 ]. We restricted the study population to people affiliated with the French general health insurance scheme for at least 5 years at inclusion so that we could assess medical history.…”

Section: Methodsmentioning

confidence: 99%

Do Proton Pump Inhibitors Reduce Upper Gastrointestinal Bleeding in Older Patients with Atrial Fibrillation Treated with Oral Anticoagulants? A Nationwide Cohort Study in France

Drusch,

Neumann,

Michelon

et al. 2023

Drugs Aging

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Background Proton pump inhibitors (PPIs) are largely used in older adults and data are needed in off-label indications, such as the prevention of upper gastrointestinal bleeding (UGIB) in patients receiving oral anticoagulants (OACs). This study aimed to assess whether PPIs reduce the risk of UGIB in patients initiating oral anticoagulation. Methods We conducted a longitudinal study based on the French national health database. The study population included 109,693 patients aged 75–110 years with a diagnosis of atrial fibrillation who initiated OACs [vitamin K antagonist (VKA) or direct OAC (DOAC)] between 2012 and 2016. We used multivariable Cox models weighted by inverse of probability of treatment to estimate the adjusted hazard ratio (aHR) of UGIB between PPI users and nonusers over a 6- and 12-month follow-up. Results PPI users represented 23% of the study population (28% among VKA initiators and 17% among DOAC initiators). The mean age (83 ± 5.3 years) and proportion of women (near 60%) were similar between groups. The risk of UGIB in the first 6 months after initiation of OAC decreased by 20% in PPI users compared with PPI nonusers [aHR 6 months = 0.80, 95% confidence interval (CI) 0.65–0.98], but was not significantly modified when the follow-up was extended to 12 months (aHR 12 months = 0.90, 95% CI 0.76–1.07), with a stronger effect among patients treated with vitamin K antagonists (aHR 6 months = 0.73, 95% CI 0.58–0.93; aHR 12 months = 0.81, 95% CI 0.67–0.99). Conclusions This study suggests that PPIs were associated with reduced risk of gastrointestinal bleeding after initiation of oral anticoagulation in older patients with atrial fibrillation, particularly within 6 months after initiation of an antivitamin K antagonist. Supplementary Information The online version contains supplementary material available at 10.1007/s40266-023-01085-7.

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Section: Methodsmentioning

confidence: 99%

Do Proton Pump Inhibitors Reduce Upper Gastrointestinal Bleeding in Older Patients with Atrial Fibrillation Treated with Oral Anticoagulants? A Nationwide Cohort Study in France

Drusch,

Neumann,

Michelon

et al. 2023

Drugs Aging

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“… Define timeframe for drug therapy evaluation. Initiate therapy with specific prescription details and consider non-pharmacologic alternatives Provide information, instructions, and warnings Assess therapy regularly (e.g., monitor treatment results and consider discontinuation of the drug) Monitoring should be performed to identify if patients are developing adverse drug events, such as falls or cognitive, motoric or sensory impairment Consider drug costs for patients and society when prescribing Use clinical decision support systems and other tools to reduce prescribing errors There are numerous explicit tools, which can be used to guide appropriate prescribing including STOPP/START, STOPPFall, STOPPFrail, Beers criteria, FORTA, TIME, REMEDI[e]S, and Web-based Meds75 + guide [ 13 , 31 , 32 , 38 ]. …”

Section: Before Considering Prescribing Fall-risk-increasing Drugsmentioning

confidence: 99%

“…Use clinical decision support systems and other tools to reduce prescribing errors There are numerous explicit tools, which can be used to guide appropriate prescribing including STOPP/START, STOPPFall, STOPPFrail, Beers criteria, FORTA, TIME, REMEDI[e]S, and Web-based Meds75 + guide [ 13 , 31 , 32 , 38 ]. …”

Section: Before Considering Prescribing Fall-risk-increasing Drugsmentioning

confidence: 99%

European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: implications and implementation

et al. 2023

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Falls prevention and management in older adults is a critical global challenge. One of the key risk factors for falls is the use of certain medications. Therefore, to prevent medication-related falls, the following is recommended in the recent World Guidelines for Falls Prevention and Management: (1) assess for fall history and the risk of falls before prescribing potential fall-risk-increasing drugs (FRIDs), (2) use a validated, structured screening and assessment tool to identify FRIDs when performing a medication review, (3) include medication review and appropriate deprescribing of FRIDs as a part of the multifactorial falls prevention intervention, and (4) in long-term care residents, if multifactorial intervention cannot be conducted due to limited resources, the falls prevention strategy should still always include deprescribing of FRIDs.In the present statement paper, the working group on medication-related falls of the World Guidelines for Falls Prevention and Management, in collaboration with the European Geriatric Medicine Society (EuGMS) Task and Finish group on FRIDs, outlines its position on how to implement and execute these recommendations in clinical practice.Preferably, the medication review should be conducted as part of a comprehensive geriatric assessment to produce a personalized and patient-centered assessment. Furthermore, the major pitfall of the published intervention studies so far is the suboptimal implementation of medication review and deprescribing. For the future, it is important to focus on gaining which elements determine successful implementation and apply the concepts of implementation science to decrease the gap between research and practice.

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“…Among the elderly, polypharmacy also increases the risk of receiving potentially inappropriate medications (PIM). PIMs are described as medications which should be avoided in older adults, as detailed on the Beers list of the American Geriatric Society [ 8 ] and adapted to the drug markets and prescribing preferences of other countries, e.g., Japan [ 9 ], France [ 10 ] and Germany [ 11 ]. The use of drugs on PIM-lists is associated with a higher risk of ADEs [ 12 , 13 ] and also mortality [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

Stolz,

Krause,

Junius-Walker

et al. 2023

Aging Clin Exp Res

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Background Nursing home residents (NHR) show high rates of polypharmacy. The HIOPP-3-iTBX study is the first cRCT on medication optimization in nursing homes (NH) in Germany. The intervention did not result in a reduction of PIM and/or antipsychotics. This analysis looks at structure quality in the HIOPP-3-iTBX study participants. Aims Evaluation of structure quality as part of a cluster-randomized controlled intervention study. Methods Structure quality in multiprofessional teams from n = 44 NH (n = 44 NH directors, n = 91 family doctors (FD), and n = 52 pharmacies with n = 62 pharmacists) was assessed using self-designed questionnaires at baseline. Main aspects of the questionnaires related to the qualification of participants, quality management, the medication process and size of the facilities. All completed questionnaires were included. number of PIM/antipsychotics was drawn from the baseline medication analysis in 692 NHR. Data were analyzed by descriptive statistics and mixed model logistic regression. Results The presence of a nurse with one of the additional qualifications pain nurse or Zertifiziertes Curriculum (Zercur) Geriatrie in the participating NH was associated with a lower risk for the prescription of PIM/antipsychotics. No association between any characteristic in the other participants at baseline was observed. Conclusions and discussion The results support the known role of nursing qualification in the quality and safety of care. Further studies need to look more closely at how use is made of the additional qualifications within the multiprofessional teams. Perspectively, the results can contribute to the development of quality standards in NH in Germany.

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REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria

Cited by 20 publications

References 58 publications

Do Proton Pump Inhibitors Reduce Upper Gastrointestinal Bleeding in Older Patients with Atrial Fibrillation Treated with Oral Anticoagulants? A Nationwide Cohort Study in France

Do Proton Pump Inhibitors Reduce Upper Gastrointestinal Bleeding in Older Patients with Atrial Fibrillation Treated with Oral Anticoagulants? A Nationwide Cohort Study in France

European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: implications and implementation

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study

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