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Potentially Inadequate Medications in the Elderly: PRISCUS 2.0.

Nina-Kristin Mann1, Tim Mathes, Andreas Sönnichsen

  • 1Chair of Clinical Pharmacology, Department of Medicine, Faculty of Health, University of Witten/Herdecke; Institute of Medical Statistics, Faculty of Medicine, University of Göttingen; Institute of Knowledge Management in Medicine, Salzburg, Austria; Institute for Research in Operative Medicine, Department of Medicine, Faculty of Health, University of Witten/Herdecke; Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Austria; Department of General and Family Medicine, Center for Public Health, Medical University of Vienna, Austria; Philipp Klee Institute of Clinical Pharmacology, Helios University Hospital, Wuppertal.

Deutsches Arzteblatt International
|December 12, 2022
PubMed
Summary
This summary is machine-generated.

A revised PRISCUS list identifies 187 potentially inadequate medications (PIM) for older adults. This updated list, including new drug classes, aims to improve medication safety and reduce PIM prescriptions in the elderly.

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Area of Science:

  • Geriatric Pharmacology
  • Drug Safety in the Elderly

Background:

  • Potentially Inadequate Medications (PIM) are drugs unsuitable for elderly patients.
  • The original PRISCUS list (2010) was the first PIM catalog for the German market.
  • PIM prescriptions for German patients aged ≥65 decreased from 24% in 2009 to 14.5% in 2019.

Purpose of the Study:

  • To update and expand the PRISCUS list of potentially inadequate medications for the elderly.
  • To evaluate drug suitability for geriatric populations through expert consensus.

Main Methods:

  • A three-round Delphi process involving clinical and research experts.
  • Evaluation of selected drug substances using dedicated literature and systematic reviews.
  • Inclusion of comments and therapeutic alternatives from experts.

Main Results:

  • 187 substances were classified as PIM.
  • 133 substances were new additions not on the original PRISCUS list.
  • New PIM include oral antidiabetics, COX-2 inhibitors, oxazepam, and specific durations/dosages for PPIs, ibuprofen, and risperidone.

Conclusions:

  • The updated PRISCUS list is significantly expanded.
  • Further validation through epidemiological and prospective studies is required.
  • Practicability in routine clinical use needs verification.