Skip to main content

Advertisement

SpringerLink
Log in

Spanish list of potentially inappropriate drugs in the elderly (ES-PIA project)

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

In the last decades, different criteria have been developed for detecting inappropriate prescription in older patients. In Spain, translations and adaptations of international lists are available but it would be necessary a national list which could cope with the peculiarities of our health system, existing pharmaceutical market, and prescription habits. We propose in this project the creation of a Spanish potentially inappropriate drugs list which could be applicable in our clinical scenario.

Methods

We use a Delphi method involving 25 experts from different backgrounds (Clinical Pharmacology, Geriatrics, Rational Use of Drugs and Pharmacy, Primary Care and Pharmacoepidemiology, and Pharmacovigilance) that were asked to participate in two-round questionnaires.

For analysis, current recommendations of Worth and Pigni were applied, and every statement was classified into one of three groups: strong, moderate, or low agreement. Statements with strong agreement were accepted to be part of the inadequate prescription list. Moderate agreement statements were selected to enter the second questionnaire, and statements with low agreement were further analyzed to determine if it was due to heterogeneity or due to dispersion in the answers.

Results

The first questionnaire consisted of 160 proposed sentences, of which 106 reached a high agreement, 32 a moderate agreement, and 22 a low agreement. All sentences proposed in the second questionnaire reached a strong agreement. The total accepted sentences were 138.

Conclusions

We offer a list of inadequate prescription in older patients adapted to the Spanish pharmacopeia and according to the prescription habits in our environment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lavan AH, Gallagher PF, O’Mahony D (2016) Methods to reduce prescribing errors in elderly patients with multimorbidity. Clin Interv Aging 23(11):857–866

    Google Scholar 

  2. Heaton A, Webb DJ, Maxwell SR (2008) Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates. Br J Clin Pharmacol 66(1):128–134

    Article  PubMed  PubMed Central  Google Scholar 

  3. BOLCAN (2012). Seguridad en la prescripción del paciente crónico polimedicado. Servicio Canario de la Salud. Boletín canario de uso racional del medicamento del SCS, n° 3, Noviembre

  4. Gavilán-Moral E, Villafaina-Barroso A, Jiménez-de Gracia L, Gómez Santana Mdel C (2012) Polypharmacy in frail elderly patients: is deprescribing the answer? Rev Esp Geriatr Gerontol 47:162–167

    Article  PubMed  Google Scholar 

  5. Hortal Carmona J, Aguilar Cruz I, Parrilla Ruiz F (2015) A prudent deprescription model. Med Clin (Barc) 144(8):362–369

    Article  Google Scholar 

  6. American Geriatrics Society (2012) Beers Criteria Update Expert Panel (2012). American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 60:616–631

    Article  Google Scholar 

  7. By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel (2015) American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc 63:2227–2246

    Article  Google Scholar 

  8. Pastor Cano J, Aranda García A, Gascón Cánovas JJ, Rausell Rausell VJ, Tobaruela Soto M (2015) Adaptación española de los criterios Beers. An Sist Sanit Navar 38:375–385

    Article  CAS  PubMed  Google Scholar 

  9. Gallagher P, Ryan C, Byrne S, Kennedy J, O’Mahony D (2008) STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther 46:72–83

    Article  CAS  PubMed  Google Scholar 

  10. O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P (2015) STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing 44:213–218

    Article  PubMed  Google Scholar 

  11. Laroche ML, Charmes JP, Merle L (2007) Potentially inappropriate medications in the elderly: a French consensus panel list. Eur J Clin Pharmacol 63:725–731

    Article  PubMed  Google Scholar 

  12. Laroche ML, Bouthier F, Merle L, Charmes JP (2009) Potentially inappropriate medications in the elderly: a list adapted to French medical practice. Rev Med Interne 30:592–601

    Article  PubMed  Google Scholar 

  13. Holt S, Schmiedl S, Thurmann PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 107:543–551

    PubMed  PubMed Central  Google Scholar 

  14. Mc Leod PJ, Huang AR, Tamblyn RM, Gayton DC (1997) Defining inappropriate practices in prescribing for elderly people: a national consensus panel. Can Med Assoc J 156:385–391

    CAS  Google Scholar 

  15. Naugler CT, Brymer C, Stolee P, Arcese ZA (2000) Development and validation of an improved prescribing in the elderly tool. Can J Clin Pharmacol 7:103–107

    CAS  PubMed  Google Scholar 

  16. 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 27:153–159

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hanlon JT, Schmader KE, Samsa GP, Weinberger M, Uttech KM, Lewis IK, Cohen HJ, Feussner JR (1992) A method of assessing drug therapy appropriateness. J Clin Epidemiol 45:1045–1051

    Article  CAS  PubMed  Google Scholar 

  18. Samsa GP, Hanlon JT, Schmader KE, Weinberger M, Clipp EC, Uttech KM, Lewis IK, Landsman PB, Cohen HJ (1994) A summated score for the medication appropriateness index: development and assessment of clinimetric properties including content validity. J Clin Epidemiol 47:891–896

    Article  CAS  PubMed  Google Scholar 

  19. Delgado Silveira E, Muñoz García M, Montero Errasquin B, Sánchez Castellano C, Gallagher PF, Cruz-Jentoft AJ (2009) Inappropriate prescription in older patients: the STOPP/START criteria. Rev Esp Geriatr Gerontol 44:273–279

    Article  PubMed  Google Scholar 

  20. Delgado Silveira E, Montero Errasquín B, Muñoz García M, Vélez-Díaz-Pallarés M, Lozano Montoya I, Sánchez-Castellano C, Cruz-Jentoft AJ (2015) Improving drug prescribing in the elderly: a new edition of STOPP/START criteria. Rev Esp Geriatr Gerontol 50(2):89–96

    Article  CAS  PubMed  Google Scholar 

  21. Nicieza-García ML, Salgueiro-Vázquez ME, Jimeno-Demuth FJ, Manso G (2016) Beers versus STOPP criteria in polypharmacy community-dwelling older patients. In: Farm Hosp, vol 40, pp 150–164

    Google Scholar 

  22. Filomena Paci J, García Alfaro M, Redondo Alonso FJ, Fernández San-Martín MI, Grupo Polimedicación Litoral (2015) Prescripción inadecuada en pacientes polimedicados mayores de 64 años en atención primaria. Aten Primaria 47:38–47

    Article  PubMed  Google Scholar 

  23. Pastor Cano C et al (2018) Prescripción potencialmente inadecuada en mayores de 65 años según los criterios de Beers originales y su versión adaptada. Aten Primaria 50(2):106–113

    Article  PubMed  Google Scholar 

  24. INFORME 2014 Las Personas Mayores en España Datos Estadísticos Estatales y por Comunidades Autónomas Colección Documentos Serie Documentos Estadísticos N° 22029. Available in https://www.ine.es/ (last search 22th October 2018)

  25. Martin-Pérez M, López de Andrés A, Hernández-Barrera V, Jiménez-García R, Jiménez-Trujillo I, Palacios-Ceñab D, Carrasco-Garrido P (2017) Prevalence of polypharmacy among the population older than 65 years in Spain: analysis of the 2006 and 2011/12 National Health Surveys. Rev Esp Geriatr Gerontol 52(1):2–8

    Article  PubMed  Google Scholar 

  26. Resultados de la Encuesta Europea de Salud en España EESE 2014 (2017). Ministerio de Sanidad, Servicios Sociales e Igualdad

  27. Mena Mateo JM, de la Fuente AS, Cañada Dorado A, Villamor Borrego M (2009) Strategy for implementing and assessing a health care risk management unit in a primary care area. Rev Calid Asist 24(3):95–103

    Article  PubMed  Google Scholar 

  28. Varela-Ruiz M et al (2012) Descripción y usos del método Delphi en investigaciones del área de la salud. Inv Ed Med 1(2):90–95

    Google Scholar 

  29. Montpart Costa E y Martín Barea MP (2003). El Sistema Español de Farmacovigilancia. OFFARM 22 (2): 120–128

  30. Lindquist M. Vigibase 2008. The WHO global ICSR database system: basic facts. Drug Information Journal 42:409–419,

  31. The Anatomical Therapeutic Chemical (ATC) classification. Last updated: WHO Collaborating Centre for Drug Statistics Methodology (2018-02-15). Available in https://www.whocc.no/atc/structure_and_principles/ (last search 22th October 2018)

  32. Worth A et al (2010) Key components of anaphylaxis management plans: consensus findings from a national electronic Delphi study. JRSM Short Rep 1(5):42

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kruskal WH, Wallis WA (1952) Use of ranks in one-criterion variance analysis. J Am Stat Assoc 47(260):583–621

    Article  Google Scholar 

  34. Blanco-Reina E, Ariza-Zafra G, Ocaña-Riola R, León-Ortiz M (2014) 2012 American Geriatrics Society Beers criteria: enhanced applicability for detecting potentially inappropriate medications in European older adults? A comparison with the screening tool of older Person’s potentially inappropriate prescriptions. J Am Geriatr Soc 62:1217–1223

    Article  PubMed  Google Scholar 

  35. Basger BJ, Chen TF, Moles RJ (2008) Inappropriate medication use and prescribing indicators in elderly Australians. Development of a Prescribing Indicators Tool Drugs Aging 25(9):777–793

    PubMed  Google Scholar 

  36. Hurria A, Lichtman SM (2007) Pharmacokinetics of chemotherapy in the older patient. Cancer Control 14(1):32–43

    Article  PubMed  Google Scholar 

  37. Wildiers H, Highley MS, de Bruijn EA, van Oosterom AT (2003) Pharmacology of anticancer drugs in the elderly population. Clin Pharmacokinet 42(14):1213–1242

    Article  CAS  PubMed  Google Scholar 

  38. Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, Lichtman SM, Gajra A, Bhatia S, Katheria V, Klapper S, Hansen K, Ramani R, Lachs M, Wong FL, Tew WP (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29(25):3457–3465

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Molina-Garrido MJ, Guillén-Ponce C, Muriel A (2017) Loss of organic reserve as a detector of frailty in elderly cancer patients treated with chemotherapy. J Geriatr Med Gerontol 3:024. https://doi.org/10.23937/2469-5858/1510024

    Article  Google Scholar 

  40. Feliu J, Heredia-Soto V, Gironés R, Jiménez-Munarriz B, Saldaña J, Guillén-Ponce C, Molina-Garrido MJ (2018) Can we avoid the toxicity of chemotherapy in elderly cancer patients? Crit Rev Oncol Hematol 131:16–23

    Article  PubMed  Google Scholar 

  41. Soiza RL, Subbarayan S, Antonio C, Cruz-Jentoft AJ, Petrovic M, Gudmundsson A, O’Mahony D (2017) The SENATOR project: developing and trialling a novel software engine to optimize medications and nonpharmacological therapy in older people with multimorbidity and polypharmacy. Ther Adv Drug Saf 8(3):81–85

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. UCICEC, University Hospital of Canary Islands, Ofra s/n. La Cuesta, 38320, La Laguna, Tenerife, Spain

    Magali Gonzalez-Colaço Harmand, Ana María Aldea-Perona & Mar García Sáiz

  2. Servei de Farmacologia clínica, Hospital del Mar, Barcelona, Spain

    Ana María Aldea-Perona

  3. IMIM (Institut Hospital del Mar d’Investigacions Mèdiques), Barcelona, Spain

    Ana María Aldea-Perona

  4. Servicio de Farmacología Clínica, University Hospital of Canary Islands, Tenerife, Spain

    Carlos Boada-Fernández del Campo, Consuelo Rodríguez-Jiménez, Paula Masiero-Aparicio, Candelaria Grillo-Grillo, Andrés Orellana-Mobilli & Mar García Sáiz

  5. Geriatric Unit, University Hospital of Getafe, Madrid, Spain

    Almudena Areosa-Sastre

  6. Centro de Farmacovigilancia e Información Terapéutica de Canarias, Servicio Canario de la Salud, Santa Cruz de Tenerife, Spain

    Marcelino García Sánchez-Colomer & Eduardo Fernández Quintana

  7. Uso Racional del Medicamento y Control de la Prestación, Dirección General de Programas Asistenciales. Servicio Canario de la Salud, Tenerife, Spain

    Mercedes Plasencia-Nuñez

Authors
  1. Magali Gonzalez-Colaço Harmand
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ana María Aldea-Perona
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carlos Boada-Fernández del Campo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Almudena Areosa-Sastre
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Consuelo Rodríguez-Jiménez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marcelino García Sánchez-Colomer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Eduardo Fernández Quintana
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mercedes Plasencia-Nuñez
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Paula Masiero-Aparicio
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Candelaria Grillo-Grillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Andrés Orellana-Mobilli
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Mar García Sáiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Carmen Duarte Diéguez
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Mercedes Hornillos Calvo
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Juan Antonio Avellana Zaragoza
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Nicolás Martínez Velilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Domingo de Guzmán Pérez Hernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Mario Ruiz González
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Encarnación Blanco Reina
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Carmen Asensio Ostos
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Ana Peiró
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Lourdes Cabrera García
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Fuensanta Hortigüela Moro
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Herlinda Pérez Alayón
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Iriana Espárrago García
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Javier Santana Quilez
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Javier Alonso Ramírez
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Carlos Fernández Oropesa
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. Mª José López Varona
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Mª Teresa Acín Gerico
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Emilio Sanz Alvarez
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. María Ángeles Martín de la Sierra
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. María José Peñalver
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Teresa Falomir Gómez
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. Jesús Ruiz Salazar
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Gabriela Elizondo Rivas
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Edmundo Rey Rodríguez
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the ES-PIA project group

Corresponding author

Correspondence to Magali Gonzalez-Colaço Harmand.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gonzalez-Colaço Harmand, M., Aldea-Perona, A.M., Boada-Fernández del Campo, C. et al. Spanish list of potentially inappropriate drugs in the elderly (ES-PIA project). Eur J Clin Pharmacol 75, 1161–1176 (2019). https://doi.org/10.1007/s00228-019-02684-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00228-019-02684-3

Keywords

Search

Navigation