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Die PRISCUS-Liste im klinischen Test

Praktikabilität und Vergleich mit internationalen PIM-Listen

The PRISCUS list in clinical routine

Practicability and comparison to international PIM lists

Zeitschrift für Gerontologie und Geriatrie volume 46, pages 35–47 (2013)Cite this article

Zusammenfassung

Hintergrund

Bestimmte Arzneistoffe gelten als potenziell ungeeignet für geriatrische Patienten; auf ihren Einsatz sollte möglichst verzichtet werden. Potenziell inadäquate Medikationen (PIM) wurden zu unterschiedlichen PIM-Listen zusammengefasst. 2010 erschien die deutsche PRISCUS-Liste. Ziel der vorliegenden Untersuchung ist die Bewertung der PRISCUS-Liste im Vergleich mit internationalen PIM-Listen.

Material und Methoden

Basierend auf ausgewählten PIM-Listen (PRISCUS, STOPP/START, Beers) wurde die Medikation von 308 Patienten einer geriatrischen Rehabilitationsklinik auf PIM untersucht. Einschlusskriterium der Patienten war ein Alter von  ≥ 65 Jahren.

Ergebnisse

Bezüglich ermittelter PIM unterlag die PRISCUS-Liste quantitativ den STOPP-Kriterien. Während des Aufenthalts erhielt jeder Patient durchschnittlich 1,2 PIM gemäß STOPP-Kriterien und 0,5 PIM nach der PRISCUS-Liste. Die geringste Anzahl lieferte die Beers-Liste (0,4 PIM).

Schlussfolgerung

Vom Einsatz der Beers-Liste sollte wegen der fehlenden Anpassung an den deutschen Arzneimittelmarkt abgesehen werden. Eine Anpassung der PRISCUS-Liste um diagnoseabhängige STOPP-Kriterien könnte dazu beitragen, Therapieerfolg und Arzneimitteltherapiesicherheit bei geriatrischen Patienten wesentlich zu verbessern.

Abstract

Background

Certain drugs are classified as potentially inappropriate medications (PIM) for the elderly. In 2010, the PRISCUS list was published, specifically designed for its applicability in the German pharmaceutical market. The aim of this study was to evaluate the PRISCUS list compared to international PIM lists.

Methods

Based on selected PIM lists (PRISCUS, STOPP/START, Beers), the medications of 308 patients at a clinic of geriatric rehabilitation were screened for PIMs. Applying START criteria, omission of indicated drug therapies was detected.

Results

Regarding the rate of PIM detection, the PRISCUS list was less sensitive than the application of STOPP criteria. While hospitalized, the mean number of administered PIMs per patient was 1.2 based on STOPP criteria and 0.5 based on the PRISCUS list. The lowest number of PIMs per patient was detected by applying the Beers list (0.4 PIMs).

Conclusion

The Beers list should not be used in the German pharmaceutical market. The amendment of diagnosis-related STOPP criteria to the PRISCUS list would be useful to significantly advance therapeutic success and drug safety in the elderly.

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Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

Danksagung

Diese Untersuchung wurde von der Apothekerstiftung Westfalen-Lippe in Rahmen einer Projektförderung unterstützt.

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Affiliations

  1. St. Franziskus-Hospital Münster, Hohenzollernring 72, 48145, Münster, Deutschland

    S. Siebert &  M. Smollich

  2. Klinik für Geriatrische Rehabilitation Maria Frieden Telgte, Telgte, Deutschland

    B. Elkeles

  3. Institut für Pharmazeutische und Medizinische Chemie, Klinische Pharmazie, Münster, Deutschland

    G. Hempel & J. Kruse

Authors
  1. S. Siebert
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  2. B. Elkeles
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  3. G. Hempel
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  4. J. Kruse
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  5. M. Smollich
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Corresponding author

Correspondence to M. Smollich.

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Siebert, S., Elkeles, B., Hempel, G. et al. Die PRISCUS-Liste im klinischen Test. Z Gerontol Geriat 46, 35–47 (2013). https://doi.org/10.1007/s00391-012-0324-4

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  • DOI: https://doi.org/10.1007/s00391-012-0324-4

Schlüsselwörter

  • Medikationsmanagement
  • Inadäquate Verschreibung
  • Unerwünschte Nebenwirkungen
  • Ältere Patienten
  • Geriatrisches Assessment

Keywords

  • Medication therapy management
  • Inappropriate prescribing
  • Adverse effects
  • Elderly
  • Geriatric assessment