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Scientific article
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Ability to detect potentially inappropriate prescribing in older patients: comparative analysis between PIM-Check and STOPP/STARTv2

Published inEuropean journal of clinical pharmacology, vol. 77, no. 11, p. 1747-1756
Publication date2021-11
First online date2021-06-30
Abstract

Purpose: Potentially inappropriate prescribing (PIP) is a source of preventable adverse drug events. The objective of this study was a comparative analysis (quantitative and qualitative) between two tools used to detect PIP, PIM-Check and STOPP/START.

Methods: First, a qualitative analysis (QAC) was conducted to evaluate the concordance between the criteria, which constitute PIM-Check and the gold standard STOPP/START. Second, a retrospective comparative and observational study was performed on the list of treatment at the admission of 50 older patients hospitalized in an acute geriatric ward of a university hospital in Switzerland in 2016 using both tools.

Results: The QAC has shown that 50% (57 criteria) of STOPP/START criteria are fully or partially concordant with those of PIM-Check. The retrospective study was performed on 50 patients aged 87 years, suffering from 5 co-morbidities (min-max 1-11) and treated by of 8 drugs (min-max 2-16), as medians. The prevalence of the detected PIP was 80% by PIM-Check and 90% by STOPP/START. Medication review shows that 4.2 PIP per patient were detected by PIM-Check and 3.5 PIP by STOPP/START among which 1.9 PIP was commonly detected by both tools, as means. PIM-Check detected more PIP related to cardiology, angiology, nephrology, and endocrinology in older patients but missed the PIP related to geriatric syndromes (e.g., fall, dementia, Alzheimer) detected by STOPP/START.

Conclusions: By using PIM-Check in geriatric settings, some PIP will not be detected. It is considered as a limitation for this tool in this frail population but brings a certain complementarity in other areas of therapy not covered by STOPP/START.

eng
Keywords
  • Aged
  • Medication review
  • PIM-Check
  • Potentially inappropriate medication list
  • Prescribing errors
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Geriatric Assessment / methods
  • Hospitals, University
  • Humans
  • Male
  • Polypharmacy
  • Reproducibility of Results
  • Retrospective Studies
  • Sociodemographic Factors
  • Switzerland
Citation (ISO format)
FARHAT, Akram et al. Ability to detect potentially inappropriate prescribing in older patients: comparative analysis between PIM-Check and STOPP/STARTv2. In: European journal of clinical pharmacology, 2021, vol. 77, n° 11, p. 1747–1756. doi: 10.1007/s00228-021-03171-4
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ISSN of the journal0031-6970
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