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A comprehensive look at explicit screening tools for potentially inappropriate medication: A systematic scoping
Geovana Schiavo1, Marcela Forgerini1, Rosa Camila Lucchetta1
1Department of Drugs and Medicines, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Araraquara, Brazil.
This study maps tools for identifying potentially inappropriate medications (PIMs). It highlights limited consensus among tools and suggests improvements for better clinical application and patient safety.
Area of Science:
- Pharmacovigilance
- Drug Safety
- Health Informatics
Background:
- Potentially inappropriate medications (PIMs) pose significant risks to patient health.
- Existing explicit screening tools for PIMs vary widely in their identification criteria and recommendations.
- There is a need to consolidate and evaluate these tools for improved clinical utility.
Purpose of the Study:
- To systematically map explicit screening tools for identifying PIMs.
- To analyze the characteristics, limitations, and proposed therapeutic alternatives within these tools.
- To assess the overlap and consensus among identified PIMs and their management strategies.
Main Methods:
- A systematic scoping review of PubMed and Scopus databases was conducted.
- Identified PIMs were cross-referenced with WHO and Brazilian National Lists of Essential Medicines.
- Therapeutic alternatives and clinical management strategies proposed by tools were analyzed.
Main Results:
- Fifty-eight tools identified 614 PIMs and 747 PIMs-interactions, with limited overlap between tools.
- A significant portion of PIMs and their alternatives were inconsistently identified across different tools.
- PIMs frequently listed as essential drugs in Brazil (30.6%) and by WHO (23.3%) were identified.
Conclusions:
- Further development of PIM screening tools requires enhanced consensus and improved cross-country applicability.
- Recommendations include incorporating PIM risks and evidence-based therapeutic alternatives into screening tools.
- Standardizing PIM identification and management is crucial for enhancing medication safety.
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