Search

In order to reduce problems associated with potentially inappropriate medication prescribing in geriatric patients, it´s necessary to establish appropriate regulatory measures and to increase training of medical doctors and pharmacists in problems of PIMs.Regulatory measures regarding PIM use widely differ across Europe. The aim of this study was to investigate what prescription limits are established for EU-7 PIMs in Central and Eastern European countries. To avoid ageism and ageist practices in inappropriate medication use in older patients, prescription limits for PIMs should be harmonized across Europe.

Potentially inappropriate medications (PIMs) are considered higher-risk medications in geriatrics and should be prescribed rarely and with a special cautiousness in older patients. The aim of our study was to clarify for how many PIMs geriatric dosing is stated in official drug information sources (searched between March-May 2019) using AIFA website (Agenzia Italiana Farmaco), BNF (British National Formulary) and US PDR (US Prescriber’s Drug Reference). This information was searched for all SPCs of PIMs (original drug products).

Risk factors (RFs) for potentially inappropriate medication (PIM) use in older adults have been extensively studied, but with a higher emphasis on patient-related and clinical-related RFs. However, other RFs, like social, economic and healthcare related, also contribute to PIM use in older patients in different settings of care. The objective of this study was to conduct a systematic literature review on social, economic and healthcare-provision related RFs for PIM use in older patients.

IntroductionThe importance of rational drug therapy is increasing with the aging of the population. Since one of the main reasons for inappropriate drug prescribing is also the age-blind approach, which results in ageist practices, this narrative literature review focuses on the description of the main barriers related to insufficient individualization of drug regimens associated with such age-blind approaches.MethodologyA narrative literature review using the PubMed, WoS, Embase, and Scopus databases was conducted by the EU COST Action IS1402. Experts in different scientific fields from six countries (the Czech Republic, Spain, Portugal, Hungary, Serbia, and Turkey) worked in four specific areas: (1) underrepresentation of older adults in clinical trials and clinical and ethical consequences; (2) insufficient consideration of age-related changes and geriatric frailty in the evaluation of the therapeutic value of drugs; (3) frequent prescribing of potentially inappropriate medications (PIMs); and (4) frequent underuse of highly beneficial nonpharmacological strategies (e.g., exercise).ResultsOlder patients are underrepresented in clinical trials. Therefore, rigorous observational geriatric research is needed in order to obtain evidence on the real efficacy and safety of frequently used drugs, and e.g. developed geriatric scales and frailty indexes for claims databases should help to stimulate such research. The use of PIMs, unfortunately, is still highly prevalent in Europe: 22.6% in community-dwelling older patients and 49.0% in institutionalized older adults. Specific tests to detect the majority of age-related pharmacological changes are usually not available in everyday clinical practice, which limits the estimation of drug risks and possibilities to individualize drug therapy in geriatric patients before drug prescription. Moreover, the role of somenonpharmacological strategies is highly underestimated in older adultsin contrast to frequent use of polypharmacy. Among nonpharmacological strategies, particularly physical exercise was highly effective in reducing functional decline, frailty, and the risk of falls in the majority of clinicalstudies.ConclusionSeveral regulatory and clinical barriers contribute to insufficient knowledge on the therapeutic value of drugs in older patients, age-blind approach, and inappropriate prescribing. New clinical and observational research is needed, including data on comprehensive geriatric assessment and frailty, to document the real efficacy and safety of frequently used medications.

and poster presented at the Czech national conference of clinical pharmacy about inappropriate precribing in older patients and ageist practices at regulatory level related to availability of potentially inappropriate medications in the aged.

Risk factors (RFs) for potentially inappropriate medication (PIM) use in older adults have been extensively studied, but with a higher emphasis on patient-related and clinical-related RFs. However, other RFs, like social, economic and healthcare related, also contribute to PIM use in older patients in different settings of care. The objective of this study was to conduct a systematic literature review on social, economic and healthcare-provision related RFs for PIM use in older patients.&nbsp

and poster presented at the Czech national conference of clinical pharmacy about inappropriate precribing in older patients and ageist practices at regulatory level related to availability of potentially inappropriate medications in the aged.

In order to reduce problems associated with potentially inappropriate medication prescribing in geriatric patients, it´s necessary to establish appropriate regulatory measures and to increase training of medical doctors and pharmacists in problems of PIMs.Regulatory measures regarding PIM use widely differ across Europe. The aim of this study was to investigate what prescription limits are established for EU-7 PIMs in Central and Eastern European countries. To avoid ageism and ageist practices in inappropriate medication use in older patients, prescription limits for PIMs should be harmonized across Europe.

Risk factors (RFs) for potentially inappropriate medication (PIM) use in older adults have been extensively studied, but with a higher emphasis on patient-related and clinical-related RFs. However, other RFs, like social, economic and healthcare related, also contribute to PIM use in older patients in different settings of care. The objective of this study was to conduct a systematic literature review on social, economic and healthcare-provision related RFs for PIM use in older patients.&nbsp

Potentially inappropriate medications (PIMs) are considered higher-risk medications in geriatrics and should be prescribed rarely and with a special cautiousness in older patients. The aim of our study was to clarify for how many PIMs geriatric dosing is stated in official drug information sources (searched between March-May 2019) using AIFA website (Agenzia Italiana Farmaco), BNF (British National Formulary) and US PDR (US Prescriber’s Drug Reference). This information was searched for all SPCs of PIMs (original drug products)., poster at international conference

and poster presented at the Czech national conference of clinical pharmacy about inappropriate precribing in older patients and ageist practices at regulatory level related to availability of potentially inappropriate medications in the aged.

Risk factors (RFs) for potentially inappropriate medication (PIM) use in older adults have been extensively studied, but with a higher emphasis on patient-related and clinical-related RFs. However, other RFs, like social, economic and healthcare related, also contribute to PIM use in older patients in different settings of care. The objective of this study was to conduct a systematic literature review on social, economic and healthcare-provision related RFs for PIM use in older patients., poster at international conference

In order to reduce problems associated with potentially inappropriate medication prescribing in geriatric patients, it´s necessary to establish appropriate regulatory measures and to increase training of medical doctors and pharmacists in problems of PIMs. Regulatory measures regarding PIM use widely differ across Europe. The aim of this study was to investigate what prescription limits are established for EU-7 PIMs in Central and Eastern European countries. To avoid ageism and ageist practices in inappropriate medication use in older patients, prescription limits for PIMs should be harmonized across Europe.

Potentially inappropriate medications (PIMs) are considered higher-risk medications in geriatrics and should be prescribed rarely and with a special cautiousness in older patients. The aim of our study was to clarify for how many PIMs geriatric dosing is stated in official drug information sources (searched between March-May 2019) using AIFA website (Agenzia Italiana Farmaco), BNF (British National Formulary) and US PDR (US Prescriber’s Drug Reference). This information was searched for all SPCs of PIMs (original drug products).

Potentially inappropriate medications (PIMs) are considered higher-risk medications in geriatrics and should be prescribed rarely and with a special cautiousness in older patients. The aim of our study was to clarify for how many PIMs geriatric dosing is stated in official drug information sources (searched between March-May 2019) using AIFA website (Agenzia Italiana Farmaco), BNF (British National Formulary) and US PDR (US Prescriber’s Drug Reference). This information was searched for all SPCs of PIMs (original drug products).

Background and Aim: Polypharmacy and potentially inappropriate medication (PIM) use in older populations (65+ years) have not yet been investigated by meta-analyses in developing countries. This systematic literature review and meta-analysis aimed to investigate the prevalence of polypharmacy and PIM use and major risk factors associated with PIM prescribing in older adults in Ethiopia. Methods: We searched PubMed/MEDLINE, Scopus, Embase, and Google Scholar databases to identify relevant studies published between January 1990 and October 2020. Observational studies reporting the prevalence and association of risk factors with polypharmacy and PIM use in the older population were meta-analyzed. A multilevel meta-analysis was conducted to pool the prevalence estimates, and the risk of PIM use was reported as a relative risk (RR) with a 95% confidence interval (CI). Results: We identified by systematic literature review 404 articles. Of those, 8 studies fulfilled inclusion criteria, comprising a total sample of 2,608 participants. The overall prevalence of polypharmacy and PIM use pooled by meta-analysis in the Ethiopian older population was 33 and 37%, respectively. The risk factors of PIM use were analyzed in the meta-analysis (particularly polymorbidity, polypharmacy, gender, and older age), and only older age of 65+ (RR: 1.71, 95% CI: 1.16–2.51) was significantly associated with PIM use. Conclusion: This first meta-analysis from a developing country revealed a high prevalence of polypharmacy and PIM use in the Ethiopian older population. There was no awareness about the risk of PIMs in patients with polypharmacy and polymorbidity, and older age significantly predicted PIM use. Interventions ensuring rational geriatric pharmacotherapy are essential in developing countries in order to reduce the expected burden of PIM-related geriatric morbidity, higher costs, and mortality.