European Journal of Clinical Pharmacology

, Volume 63, Issue 8, pp 725–731

Potentially inappropriate medications in the elderly: a French consensus panel list

  • Marie-Laure Laroche
  • Jean-Pierre Charmes
  • Louis Merle
Special Article

DOI: 10.1007/s00228-007-0324-2

Cite this article as:
Laroche, ML., Charmes, JP. & Merle, L. Eur J Clin Pharmacol (2007) 63: 725. doi:10.1007/s00228-007-0324-2

Abstract

Objective

To evaluate drug-related problems in the elderly, various lists of potentially inappropriate medications have been published in North America. Unfortunately, these lists are hardly applicable in France. The purpose of this study was to establish a list of inappropriate medications for French elderly using the Delphi method.

Method

A two-round Delphi method was used to converge to an agreement between a pool of 15 experts from various parts of France and from different backgrounds (five geriatricians, five pharmacologists, two pharmacists, two general practitioners, one pharmacoepidemiologist). In round one, they were sent a questionnaire based on a literature review listing medications and clinical situations. They were asked to comment on the potential inappropriateness of the criteria proposed using a 5-point Likert scale (from strong agreement to strong disagreement) and to suggest therapeutic alternatives and new criteria. In round two, the experts confirmed or cancelled their previous answers from the synthesis of the responses of round one. After round two, a final list of potentially inappropriate drugs was established.

Results

The final list proposed 36 criteria applicable to people ≥75 years of age. Twenty-nine medications or medication classes applied to all patients, and five criteria involved medications that should be avoided in specific medical conditions. Twenty-five medications or medication classes were considered with an unfavourable benefit/risk ratio, one with a questionable efficacy and eight with both unfavourable benefit/risk ratio and questionable efficacy.

Conclusion

This expert consensus should provide prescribers with an epidemiological tool, a guideline and a list of alternative therapies.

Keywords

Inappropriate medicationsElderlyDelphi methodFrance

Abbreviations

NSAID

nonsteroidal antiinflammatory drug

SNRI

serotonin and noradrenaline reuptake inhibitor

SSRI

selective serotonin reuptake inhibitor

IMs

inappropriate medications

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Marie-Laure Laroche
    • 1
  • Jean-Pierre Charmes
    • 2
  • Louis Merle
    • 1
  1. 1.Department of Pharmacology-Toxicology, Centre of PharmacovigilanceUniversity Hospital DupuytrenLimogesFrance
  2. 2.Department of GeriatricsHospital RebeyrolLimogesFrance