Monitoring of Potentially Inappropriate Prescriptions in Older Inpatients: A French Multicenter Study
- 9 October 2017
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 65 (12), 2713-2719
- https://doi.org/10.1111/jgs.15081
Abstract
To determine whether potentially inappropriate medications (PIMs) or potentially inappropriate associations (PIAs) prescribed knowingly are associated with patient monitoring. Prospective observational study. Geriatric units (n = 56) in 28 hospitals. Inpatients aged 75 and older (N = 1,327). Potentially inappropriate prescriptions (PIP) were defined as a PIM or a PIA selected by an expert board from lists of explicit criteria (Beers, Priscus, Laroche, French Health Agency) using a Delphi process. They were considered to be prescribed knowingly if they were maintained after reassessment by the geriatrician and the clinical pharmacist. Primary outcome was the rate of PIPs maintained (prescribed knowingly) and for which a geriatrician declared that specific monitoring was performed. Secondary outcomes were the parameters monitored and the rate of participants receiving knowingly a PIP. One thousand sixty-three PIPs were detected in 607 participants (46%). After reassessment, 826 (78%) PIPs were maintained in 490 participants (37%), the main reasons being participant's regular treatment and lack of alternative. Psychotropic (36%), cardiovascular (including antithrombotics) (29%), and laxative or antiemetic drugs (16%) were the most-frequent classes prescribed knowingly. The geriatricians declared to perform clinical or biological monitoring for 69% (n = 570) of PIMs or PIAs prescribed knowingly. Three types of specific monitoring were identified: clinical, biological, and follow-up with a specialist. Approximately three-quarters of PIMs or PIAs were prescribed knowingly, of which 69% were monitored, with wide variations in occurrence and in quality according to drug classes. This underlines the need for accurate guidelines on PIP monitoring.Funding Information
- AstraZeneca
This publication has 23 references indexed in Scilit:
- Drugs prescribed for patients hospitalized in a geriatric oncology unit: Potentially inappropriate medications and impact of a clinical pharmacistJournal of Geriatric Oncology, 2016
- Potentially inappropriate drug prescribing in elderly hospitalized patients: an analysis and comparison of explicit criteriaInternational Journal of Clinical Pharmacy, 2016
- American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older AdultsJournal of the American Geriatrics Society, 2015
- The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countriesEuropean Journal of Clinical Pharmacology, 2015
- STOPP/START criteria for potentially inappropriate prescribing in older people: version 2Age and Ageing, 2014
- Inappropriate PrescribingDrugs & Aging, 2012
- Emergency Hospitalizations for Adverse Drug Events in Older AmericansThe New England Journal of Medicine, 2011
- Médicaments potentiellement inappropriés aux personnes âgées : intérêt d’une liste adaptée à la pratique médicale françaiseLa Revue de Médecine Interne, 2009
- Potentially inappropriate medications in the elderly: a French consensus panel listEuropean Journal of Clinical Pharmacology, 2007
- Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patientsJournal of Clinical Pharmacy & Therapeutics, 2006