Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain
Abstract Background Potentially inappropriate medication use is prevalent among older adults in primary care, leading to increased morbidity, adverse drug reactions, hospitalizations, and mortality. This study aimed to develop and validate a tool for identifying PIMs in older adults within the prima...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-023-04271-9 |
| _version_ | 1797556587882086400 |
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| author | Roxana De las salas Claudia Vaca-González Javier Eslava-Schmalbach Catalina Torres-Espinosa Albert Figueras |
| author_facet | Roxana De las salas Claudia Vaca-González Javier Eslava-Schmalbach Catalina Torres-Espinosa Albert Figueras |
| author_sort | Roxana De las salas |
| collection | DOAJ |
| description | Abstract Background Potentially inappropriate medication use is prevalent among older adults in primary care, leading to increased morbidity, adverse drug reactions, hospitalizations, and mortality. This study aimed to develop and validate a tool for identifying PIMs in older adults within the primary care setting. The tool is composed of a list of criteria and was created based on consensus among experts from three Spanish-speaking countries, including two from Latin America. Methods A literature review was conducted to identify existing tools, and prescription patterns were evaluated in a cohort of 36,111 older adults. An electronic Delphi method, consisting of two rounds, was used to reach a formal expert consensus. The panel included 18 experts from Spain, Colombia, and Argentina. The content validity index, validity of each content item, and Kappa Fleiss statistical measure were used to establish reliability. Results Round one did not yield a consensus, but a definitive consensus was reached in round two. The resulting tool consisted of a list of 5 general recommendations per disease, along with 33 criteria related to potential problems, recommendations, and alternative therapeutic options. The overall content validity of the tool was 0.87, with a Kappa value of 0.69 (95% CI 0.64—0.73; Substantial). Conclusions The developed criteria provide a novel list that allows for a comprehensive approach to pharmacotherapy in older adults, intending to reduce inappropriate medication use, ineffective treatments, prophylactic therapies, and treatments with an unfavorable risk–benefit ratio for the given condition. Further studies are necessary to evaluate the impact of these criteria on health outcomes. |
| first_indexed | 2024-03-10T17:04:00Z |
| format | Article |
| id | doaj.art-7d10279edbcc4e8698b8e11b3cb6ff4a |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-03-10T17:04:00Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-7d10279edbcc4e8698b8e11b3cb6ff4a2023-11-20T10:51:25ZengBMCBMC Geriatrics1471-23182023-10-012311810.1186/s12877-023-04271-9Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and SpainRoxana De las salas0Claudia Vaca-González1Javier Eslava-Schmalbach2Catalina Torres-Espinosa3Albert Figueras4Department of NursingFaculty of Science, Department of Pharmacy, Universidad Nacional de ColombiaFaculty of Medicine, Department of Surgery, Universidad Nacional de ColombiaFaculty of Medicine, Department of Internal Medicine, Universidad Nacional de ColombiaFaculty of Medicine, Autonomus University of BarcelonaAbstract Background Potentially inappropriate medication use is prevalent among older adults in primary care, leading to increased morbidity, adverse drug reactions, hospitalizations, and mortality. This study aimed to develop and validate a tool for identifying PIMs in older adults within the primary care setting. The tool is composed of a list of criteria and was created based on consensus among experts from three Spanish-speaking countries, including two from Latin America. Methods A literature review was conducted to identify existing tools, and prescription patterns were evaluated in a cohort of 36,111 older adults. An electronic Delphi method, consisting of two rounds, was used to reach a formal expert consensus. The panel included 18 experts from Spain, Colombia, and Argentina. The content validity index, validity of each content item, and Kappa Fleiss statistical measure were used to establish reliability. Results Round one did not yield a consensus, but a definitive consensus was reached in round two. The resulting tool consisted of a list of 5 general recommendations per disease, along with 33 criteria related to potential problems, recommendations, and alternative therapeutic options. The overall content validity of the tool was 0.87, with a Kappa value of 0.69 (95% CI 0.64—0.73; Substantial). Conclusions The developed criteria provide a novel list that allows for a comprehensive approach to pharmacotherapy in older adults, intending to reduce inappropriate medication use, ineffective treatments, prophylactic therapies, and treatments with an unfavorable risk–benefit ratio for the given condition. Further studies are necessary to evaluate the impact of these criteria on health outcomes.https://doi.org/10.1186/s12877-023-04271-9DeprescriptionsPolypharmacyInappropriate PrescribingGeriatricsPotentially inappropriate medication |
| spellingShingle | Roxana De las salas Claudia Vaca-González Javier Eslava-Schmalbach Catalina Torres-Espinosa Albert Figueras Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain BMC Geriatrics Deprescriptions Polypharmacy Inappropriate Prescribing Geriatrics Potentially inappropriate medication |
| title | Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain |
| title_full | Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain |
| title_fullStr | Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain |
| title_full_unstemmed | Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain |
| title_short | Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain |
| title_sort | tackling potentially inappropriate prescriptions in older adults development of deprescribing criteria by consensus from experts in colombia argentina and spain |
| topic | Deprescriptions Polypharmacy Inappropriate Prescribing Geriatrics Potentially inappropriate medication |
| url | https://doi.org/10.1186/s12877-023-04271-9 |
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