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KMID : 1011320200120010001
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Journal of Pharmacoepidemiology and Risk Management
2020 Volume.12 No. 1 p.1 ~ p.7
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Review on Screening Tools for Potentially Inappropriate Medications in Older Adults
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Ah Young-Mi
Lee Ju-Yeun
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Abstract
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Older adults are at risk of adverse events associated with the use of potentially inappropriate medications (PIMs). PIMs may be defined as medications where the risk of adverse health outcomes associated with its use likely outweighs its clinical benefits when safer and more effective alternatives are available, therefore its use among older adults should be avoided. In this review, we presented the multiple implicit and explicit prescribing tools that have been developed internationally to identify potentially inappropriate prescribing and to improve prescribing in older adults. Implicit criteria, which are not drug or disease specific and depend on the clinical expertise, are quality indicators of prescribing. The Medication Appropriateness Index, Prescribing Optimization Method, Preventing Hospital Admissions by Reviewing Medication developed by Netherlands are the examples of implicit criteria. Since the first explicit prescribing tool, the Beers’ criteria, developed in the United States in 1991, many explicit criteria for specific countries such as McLeod criteria,
French criteria, NORGEP criteria, PRISCUS, Australian Prescribing Indicators Tool, the Screening Tool of Older People’s
potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert physicians to the Right Treatment (START)
criteria, and EURO-FORTA (Fit fOR The Aged) has been developed and updated through systematic literature review
and expertise consensus. Consensus list of PIMs for Korean older adults was also developed. The prevalent classes of
PIM were long acting benzodiazepines, hypnotics, typical antipsychotics, long-term use of traditional nonsteroidal anti-inflammatory drugs, tricyclic antidepressants, and anticholinergics such as first generation antihistamines and antispasmodics. Negative clinical outcomes associated with the use of PIMs were also reviewed.
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KEYWORD
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Potentially inappropriate medication list, Aged, Inappropriate prescribing
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