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Related Experiment Video

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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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Potentially Inappropriate Medication Use in Primary Care in Switzerland.

Simeon Schietzel¹, Stefan Zechmann², Yael Rachamin²

¹Division of Nephrology and Hypertension, Inselspital, University Hospital of Bern, University of Bern, Bern, Switzerland.

JAMA Network Open

|June 21, 2024

Summary

Potentially inappropriate medication (PIM) use is common in older adults, increasing with age. Focusing on a few key drug classes can help clinicians reduce PIM prescriptions and improve patient safety.

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Area of Science:

Geriatric Medicine
Pharmacology
Public Health

Background:

Potentially inappropriate medication (PIM) use in older adults increases adverse outcomes.
Existing PIM criteria lists are complex and data on PIM prescribing is limited.

Purpose of the Study:

To determine the prevalence and frequency of PIMs in Swiss primary care patients aged 65+.
To compare PIM identification across six major PIM lists.
To synthesize best practices for PIM management.

Main Methods:

Cross-sectional study using anonymized electronic health records from the Swiss FIRE project (2020-2021).
Included 115,867 patients aged 65+ with 1,211,227 prescriptions.
Analyzed PIM prevalence and frequency using six established PIM lists (Beers, Laroche, NORGEP, PRISCUS, Mann, EU[7]).

Main Results:

Overall PIM prevalence was 52.3% using a combined list, increasing with age.
PIM prevalence varied significantly by list (12.7% to 52.3%).
Top PIMs included pantoprazole, ibuprofen, and diclofenac, primarily from analgesics, PPIs, and benzodiazepines.

Conclusions:

PIM prevalence is high in older adults and varies by criteria, increasing with age.
A manageable number of drug classes contribute to the majority of PIM prescriptions.
Targeted deprescribing of common PIMs is crucial for improving patient safety.