European repository of explicit criteria of potentially inappropriate medications in old age

Geriatr Gerontol Int. 2018 Aug;18(8):1293-1297. doi: 10.1111/ggi.13331. Epub 2018 Apr 17.

Abstract

Aim: Lack of electronic assessment of medication lists in electronic health records is a barrier for more generalized use of potentially inappropriate medications (PIM) lists, designed for older adults. The aim was to construct a European repository of explicit criteria on PIM, suitable for electronic assessment.

Methods: PIM description, medication information, clinical information and level of evidence was entered. Criteria with unclear medication specifications were excluded. Too complex criteria were divided for more operable use.

Results: We selected three lists: the European Union (7)-PIM (2015), STOPP/START (2014) and Beers criteria (2015). After exclusion and division, from 641 original criteria of the three PIM-lists, a total of 650 criteria were entered (n = 282 from European Union (7)-PIM, n = 201 from Beers and n = 167 from the STOPP/START list). Identification of the medication was possible with the Anatomical Therapeutic Chemical Classification System for practically all criteria, except for 23 (3.5%). From all criteria, 63.9% required only medication-related information. In 55.7% of the criteria, identification of the active substance(s) was the only medication data requirement and 8.2% required additional information (dose, duration, route of administration). From all criteria, 36.1% required clinical information, from which 17.8% requested disease information only, and 18.3% required additional information (indication, history of diseases, laboratory results or severity of diseases).

Conclusions: It was feasible to enter most of the original criteria of the three PIM lists into a repository of electronically applicable criteria. In the future, developers of new PIM lists should take into account semantic interoperability and consider the suitability of the criteria for electronic use. Geriatr Gerontol Int 2018; 18: 1293-1297.

Keywords: bio-medical engineering/medical informatics; clinical pharmacology; geriatric medicine; health science; pharmaceutics.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / drug effects*
  • Databases, Factual
  • European Union
  • Female
  • Geriatric Assessment / methods
  • Humans
  • Inappropriate Prescribing / prevention & control*
  • Inappropriate Prescribing / statistics & numerical data
  • Male
  • Observer Variation
  • Potentially Inappropriate Medication List / standards*
  • Practice Guidelines as Topic / standards*
  • Risk Assessment