Artikel
Updating and expanding the PRISCUS list – Results from the Delphi survey
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Veröffentlicht: | 10. November 2021 |
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Background: Lists of potentially inappropriate medication (PIM) can be used to improve geriatric pharmacotherapy. The German PRISCUS list [1] was the first PIM list for older patients, which was created specifically with the German drug market in mind. As the PRISCUS list was published in 2010, it has become out of date and was thus updated by a group of researchers from Germany and Austria.
Materials and Methods: Drugs were selected using the original PRISCUS list [1] and other international PIM lists, for example the EU(7) list [2] and the Beers criteria [3]. Experts in research and clinical practice regarding older patients rated the appropriateness of each drug in this population during a 2 round Delphi survey. To support the experts, a comprehensive body of literature was provided, including a set of systematic reviews conducted in the context of this project. After the second round of the survey, a preliminary list was made available for public consultation for a restricted amount of time.
Results: After the Delphi survey, 187 drugs/drug classes were rated as PIM out of 250 pre-selected drugs and modified criteria added between rounds based on expert commentary. While 36 drugs received a definite rating as not-PIM, for 45 drugs no conclusive rating as either PIM or not-PIM resulted after 2 rounds. In comparison to the 2010 version of the PRISCUS list, 6 drugs were removed, 1 drug was no longer PIM and 133 new drugs and drug classes were added. Expert and public consultation provided alternative treatments for drugs rated PIM, as well as monitoring strategies when PIM use is unavoidable in an individual patient.
Conclusion: An updated version of the PRISCUS list was established in a 2 round Delphi process. While some drugs were removed, overall the PRISCUS list 2.0 was expanded showing that an update was necessary to account for more drugs now being considered PIM than during the original project.
Funding: BMBF 01KX1812
References
- 1.
- Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int. 2010 Aug;107(31-32):543-51. DOI: 10.3238/arztebl.2010.0543
- 2.
- Renom-Guiteras A, Meyer G, Thürmann PA. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015 Jul;71(7):861-75. DOI: 10.1007/s00228-015-1860-9
- 3.
- American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr;67(4):674-94. DOI: 10.1111/jgs.15767