gms | German Medical Science

15. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

20.11. - 21.11.2008, Bonn

Development of a list of potentially inappropriate medications in the elderly

Entwicklung einer Liste potentiell inadäquater Medikation bei Älteren

Meeting Abstract

Suche in Medline nach

  • corresponding author S. Holt - Philipp Klee-Institut for Clinical Pharmacology, HELIOS Klinikum Wuppertal, Department of Clinical Pharmacology, University Witten/Herdecke, Wuppertal, Germany
  • S. Schmiedl - Philipp Klee-Institut for Clinical Pharmacology, HELIOS Klinikum Wuppertal, Department of Clinical Pharmacology, University Witten/Herdecke, Wuppertal, Germany
  • P.A. Thürmann - Philipp Klee-Institut for Clinical Pharmacology, HELIOS Klinikum Wuppertal, Department of Clinical Pharmacology, University Witten/Herdecke, Wuppertal, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 15. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Bonn, 20.-21.11.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. Doc08gaa23

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gaa2008/08gaa23.shtml

Veröffentlicht: 6. November 2008

© 2008 Holt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background and aim: In elderly patients certain drugs are classified as potentially inappropriate medication (PIM) due to their increased risk for causing adverse drug reactions [Fick et al., 2003]. Due to international differences in drug availability, prescription behaviour and guidelines, published PIM lists may not be suitable for Germany.

In this subproject of PRISCUS (http://www.priscus.net SP3) existing PIM lists will be adapted to the German drug market.

Material and method: We performed a literature search of established PIM-lists. Furthermore we searched the literature for all drug classes and single agents mentioned in the established lists for evidence on increased risk in the elderly. After creating a preliminary list with PIM, a modified Delphi survey [RAND Corporation 1969] will be performed in a German expert panel of clinical pharmacologists, pharmacists, geriatricians and general practitioners. The options will include “should definitely not be used in the elderly”, “may be used with special monitoring” as well as alternative drugs.

Results: Our preliminary list includes 21 different drug classes. We adapted our PIM list to the German situation using the “Rote Liste” and the “Arzneiverordnungsreport 2007” [Schwabe, Paffrath 2007]. Surprisingly, for a number of drugs the evidence for increased risks in the elderly was very poor, although these drugs are included in established PIM lists: amiodarone, methyldopa. Some drugs from the international PIM lists [Beers 1997; McLeod et al. 1997; Fick et al. 2003; Laroche et al. 2007] will not be found on our preliminary list, e.g. ketorolac, whereas we included others, e.g. typical and atypical antipsychotics.

Conclusion: Established PIM lists are not suitable for Germany. After Delphi rounds our preliminary PIM list will be applied to prescription data of several cohorts of elderly patients investigating the relationship between use of these PIM-drugs and the occurrence of adverse events.

Supported by BMBF Fö-Nr. 01ET0721