Potentially inappropriate medicines for older people: consensus-based lists.

Area of Science:

• Geriatric Pharmacology
• Medication Safety
• Clinical Pharmacy

Background:

• Older adults, particularly those with multiple health conditions and complex medication regimens, are disproportionately susceptible to adverse drug events.
• Potentially inappropriate medicines (PIMs) are medications where risks typically exceed benefits for specific patient groups.
• Existing PIMs lists, such as the Beers Criteria and STOPP, guide safer prescribing for elderly populations.

Purpose of the Study:

• To introduce and describe the newly developed Australian PIMs list (2024).
• To provide evidence-based guidance on medications to avoid in older people, considering both general use and specific clinical contexts.
• To offer recommendations for potentially safer alternative medications.

Main Methods:

• Development of a new Australian list of potentially inappropriate medicines (PIMs) for older people, published in 2024.
• Identification of medicines to be avoided in all older individuals and those to be avoided in specific clinical situations.
• Inclusion of guidance on alternative, safer pharmacological options.

Main Results:

• The 2024 Australian PIMs list categorizes medications based on their potential inappropriateness in older adults.
• It distinguishes between medicines to avoid universally and those to avoid in particular clinical scenarios.
• The list also provides actionable recommendations for safer therapeutic alternatives.

Conclusions:

• The Australian PIMs list serves as a crucial tool for optimizing medication safety in the elderly.
• It highlights the importance of individualized prescribing, acknowledging that PIMs may be appropriate in certain clinical contexts.
• The guidelines encourage healthcare professionals to consider patient-specific factors and goals of care when making prescribing decisions.