Potentially inappropriate medication in the elderly: a systematic review of validated explicit criteria
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Potentially inappropriate medication (PIM) use causes preventable adverse drug reactions in older patients. Several assessment tools have been published to identify and avoid PIM use. In this systematic literature review, we aim to provide summaries and comparisons of validated PIMs lists published between 1991 and 2017 internationally.
In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), we performed a systematic review of articles describing the development and validation of criteria for identification of PIMs among older people published between January 1991 and April 2017. The searches were conducted on PUBMED, AgeLine, Academic Search, Academic Search Premier, and CINAHL. We identified the most common medications/classes described as PIM. We also identified the drug–disease interactions and drug–drug interactions reported among criteria.
From 2933 articles screened, 36 met our inclusion criteria. The majority used the Delphi method to validate their criteria. We identified 907 different medications/classes, 536 different drug disease interactions involving 84 diseases/conditions, and 159 drug–drug interactions. Benzodiazepines and nonsteroidal anti-inflammatory drugs were the medications most commonly reported as potentially inappropriate for older people.
Although approaches aimed at detecting inappropriate prescribing have intensified in recent years, we observed limited overlap between different PIM lists. Additionally, some PIM lists did not provide special considerations of use and alternative therapies to avoid PIMs. These facts may compromise the use of PIM lists in clinical practice. Future PIM lists should integrate information about alternative therapies and special considerations of use in order to help clinicians in the drug prescription.
KeywordsInappropriate prescribing Potentially inappropriate medication list Drug-related side effects and adverse reactions Aged
We thank to the Coordination for the Improvement of Higher Education Personnel, National Council for Scientific and Technological Development for the support that they are providing for development of this study.
FRM and VPM participated in all stages of this project, from the design and interpretation of data to its final writing. FRM and JSF conducted the development of search strategies, selection procedure, data extraction, data synthesis, and analysis. EVP contributed to the database organization and data extraction. SNH contributed to the critical review and writing of this manuscript. All authors participated in the discussions, result interpretation, and approved the final version of manuscript for submission.
FRM was supported by the Coordination for the Improvement of Higher Education Personnel—CAPES through a doctorate at University of Vale do Rio dos Sinos, Brazil. FRM was also supported by CAPES through a sandwich doctorate fellowship at University of Sydney, Australia (number grant: 88881.134589/2016-01). This systematic review was funded by the National Council for Scientific and Technological Development-CNPQ (number grant: 426720/2016-4). The funders were not involved in the design or conduct of the study, collection, analysis, or interpretation of the data or preparation or approval of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Dimitrow MS, Airaksinen MS, Kivela SL, Lyles A, Leikola SN (2011) Comparison of prescribing criteria to evaluate the appropriateness of drug treatment in individuals aged 65 and older: a systematic review. J Am Geriatr Soc 59(8):1521–1530. https://doi.org/10.1111/j.1532-5415.2011.03497.x CrossRefPubMedGoogle Scholar
- 2.Renom-Guiteras A, Meyer G, Thurmann PA (2015) The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol 71(7):861–875. https://doi.org/10.1007/s00228-015-1860-9 CrossRefPubMedPubMedCentralGoogle Scholar
- 3.Hedna K, Hakkarainen KM, Gyllensten H, Jonsson AK, Petzold M, Hagg S (2015) Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population-based study. Eur J Clin Pharmacol 71(12):1525–1533. https://doi.org/10.1007/s00228-015-1950-8 CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Opondo D, Eslami S, Visscher S, de Rooij SE, Verheij R, Korevaar JC, Abu-Hanna A (2012) Inappropriateness of medication prescriptions to elderly patients in the primary care setting: a systematic review. PLoS One 7(8):e43617. https://doi.org/10.1371/journal.pone.0043617 CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Cabre M, Elias L, Garcia M, Palomera E, Serra-Prat M (2017) Avoidable hospitalizations due to adverse drug reactions in an acute geriatric unit. Analysis of 3,292 patients. Med Clin. https://doi.org/10.1016/j.medcli.2017.06.075
- 13.Reich O, Rosemann T, Rapold R, Blozik E, Senn O (2014) Potentially inappropriate medication use in older patients in Swiss managed care plans: prevalence, determinants and association with hospitalization. PLoS One 9(8):e105425. https://doi.org/10.1371/journal.pone.0105425 CrossRefPubMedPubMedCentralGoogle Scholar
- 16.Muhlack DC, Hoppe LK, Weberpals J, Brenner H, Schottker B (2017) The association of potentially inappropriate medication at older age with cardiovascular events and overall mortality: a systematic review and meta-analysis of cohort studies. J Am Med Dir Assoc 18(3):211–220. https://doi.org/10.1016/j.jamda.2016.11.025 CrossRefPubMedGoogle Scholar
- 23.Castillo-Paramo A, Pardo-Lopo R, Gomez-Serranillos IR, Verdejo A, Figueiras A, Claveria A (2013) Assessment of the appropriateness of STOPP/START criteria in primary health care in Spain by the RAND method. SEMERGEN 39(8):413–420. https://doi.org/10.1016/j.semerg.2013.01.017 CrossRefPubMedGoogle Scholar
- 25.Clyne B, Bradley MC, Hughes CM, Clear D, McDonnell R, Williams D, Fahey T, Smith SM, O-Ss t (2013) Addressing potentially inappropriate prescribing in older patients: development and pilot study of an intervention in primary care (the OPTI-SCRIPT study). BMC Health Serv Res 13:307. https://doi.org/10.1186/1472-6963-13-307 CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Fialova DT, Topinkova E, Ballokova A, Matejovska-Kubesova H (2013) 2012 CZ expert consensus for potentially inappropriate medication use in old age: appropriate choice of drugs and drug dosing in geriatric patients (section I), drug-disease interactions in the old age (Section II). Klin Farmakol Farmacie 27(1):18–28Google Scholar
- 27.Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH (2003) Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 163(22):2716–2724. https://doi.org/10.1001/archinte.163.22.2716 CrossRefPubMedGoogle Scholar
- 28.Galan Retamal C, Garrido Fernandez R, Fernandez Espinola S, Ruiz Serrato A, Garcia Ordonez MA, Padilla Marin V (2014) Prevalence of potentially inappropriate medication in hospitalized elderly patients by using explicit criteria. Farm Hosp 38(4):305–316. https://doi.org/10.7399/fh.2014.38.4.1148 PubMedGoogle Scholar
- 31.Imai HB, MH FDM (2008) Development of Japanese Beers criteria for inappropriate medication use in elderly patients. Jpn Med Assoc J 137:1348–1358Google Scholar
- 32.Khodyakov D, Ochoa A, Olivieri-Mui BL, Bouwmeester C, Zarowitz BJ, Patel M, Ching D, Briesacher B (2017) Screening Tool of Older Person's Prescriptions/Screening Tools to Alert Doctors to Right Treatment medication criteria modified for U.S. nursing home setting. J Am Geriatr Soc 65(3):586–591. https://doi.org/10.1111/jgs.14689 CrossRefPubMedGoogle Scholar
- 39.Mann E, Bohmdorfer B, Fruhwald T, Roller-Wirnsberger RE, Dovjak P, Duckelmann-Hofer C, Fischer P, Rabady S, Iglseder B (2012) Potentially inappropriate medication in geriatric patients: the Austrian consensus panel list. Wien Klin Wochenschr 124(5–6):160–169. https://doi.org/10.1007/s00508-011-0061-5 CrossRefPubMedGoogle Scholar
- 42.Nyborg G, Straand J, Klovning A, Brekke M (2015) The Norwegian general practice—nursing home criteria (NORGEP-NH) for potentially inappropriate medication use: a web-based Delphi study. Scand J Prim Health Care 33(2):134–141. https://doi.org/10.3109/02813432.2015.1041833 CrossRefPubMedPubMedCentralGoogle Scholar
- 47.Rognstad S, Brekke M, Fetveit A, Spigset O, Wyller TB, Straand J (2009) The Norwegian General Practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients. A modified Delphi study. Scand J Prim Health Care 27(3):153–159. https://doi.org/10.1080/02813430902992215 CrossRefPubMedPubMedCentralGoogle Scholar
- 49.Tommelein E, Mehuys E, Petrovic M, Somers A, Van Damme C, Pattyn E, Mattelin K, Boussery K (2016) Potentially inappropriate prescribing in nursing home residents detected with the community pharmacist specific GheOP(3)S-tool. Int J Clin Pharm 38(5):1063–1068. https://doi.org/10.1007/s11096-016-0366-6 CrossRefPubMedGoogle Scholar
- 52.Cherubini A, Oristrell J, Pla X, Ruggiero C, Ferretti R, Diestre G, Clarfield AM, Crome P, Hertogh C, Lesauskaite V, Prada GI, Szczerbinska K, Topinkova E, Sinclair-Cohen J, Edbrooke D, Mills GH (2011) The persistent exclusion of older patients from ongoing clinical trials regarding heart failure. Arch Intern Med 171(6):550–556. https://doi.org/10.1001/archinternmed.2011.31 CrossRefPubMedGoogle Scholar
- 53.Crome P, Lally F, Cherubini A, Oristrell J, Beswick AD, Clarfield AM, Hertogh C, Lesauskaite V, Prada GI, Szczerbinska K, Topinkova E, Sinclair-Cohen J, Edbrooke D, Mills G (2011) Exclusion of older people from clinical trials: professional views from nine European countries participating in the PREDICT study. Drugs Aging 28(8):667–677. https://doi.org/10.2165/11591990-000000000-00000 CrossRefPubMedGoogle Scholar
- 59.Dalkey NC (1969) The Delphi method: an experimental study of group opinion. Santa Monica, CA: RAND Corporation. Available at: http://www.rand.org/pubs/research_memoranda/RM5888
- 61.Islam MM, Iqbal U, Walther B, Atique S, Dubey NK, Nguyen PA, Poly TN, Masud JH, Li YJ, Shabbir SA (2016) Benzodiazepine use and risk of dementia in the elderly population: a systematic review and meta-analysis. Neuroepidemiology 47(3–4):181–191. https://doi.org/10.1159/000454881 CrossRefPubMedGoogle Scholar
- 64.Vozoris NT, Fischer HD, Wang X, Anderson GM, Bell CM, Gershon AS, Stephenson AL, Gill SS, Rochon PA (2013) Benzodiazepine use among older adults with chronic obstructive pulmonary disease: a population-based cohort study. Drugs Aging 30(3):183–192. https://doi.org/10.1007/s40266-013-0056-1 CrossRefPubMedGoogle Scholar
- 66.Finkle WD, Der JS, Greenland S, Adams JL, Ridgeway G, Blaschke T, Wang Z, Dell RM, VanRiper KB (2011) Risk of fractures requiring hospitalization after an initial prescription for zolpidem, alprazolam, lorazepam, or diazepam in older adults. J Am Geriatr Soc 59(10):1883–1890. https://doi.org/10.1111/j.1532-5415.2011.03591.x CrossRefPubMedGoogle Scholar
- 67.Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S (2014) Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med 174(6):890–898. https://doi.org/10.1001/jamainternmed.2014.949 CrossRefPubMedGoogle Scholar
- 70.Ray WA, Stein CM, Byrd V, Shorr R, Pichert JW, Gideon P, Arnold K, Brandt KD, Pincus T, Griffin MR (2001) Educational program for physicians to reduce use of non-steroidal anti-inflammatory drugs among community-dwelling elderly persons: a randomized controlled trial. Med Care 39(5):425–435CrossRefPubMedGoogle Scholar