1. REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria
- Author
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Blandine de la Gastine, Elisabeth Polard, Valérie Gras, Marie-Laure Laroche, Karen Rudelle, Sophie Gautier, Régis Gonthier, Julie Berthou-Contreras, Jean Doucet, Marion Charenton-Blavignac, Marie-Blanche Valnet-Rabier, Jean-Baptiste Beuscart, Pernelle Noize, Barbara Roux, Thomas Tannou, Muriel Grau, Jean-Pascal Fournier, Ciblage individuel et prévention des risques de traitements immunosupresseurs et de la transplantation (IPPRITT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CHU Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Rouen, Normandie Université (NU), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Amiens-Picardie, CHU Bordeaux [Bordeaux], Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Université de Rennes (UR), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Delphi Technique ,[SDV]Life Sciences [q-bio] ,Implicit criteria ,Delphi method ,Inappropriate prescribing ,Pharmacy ,030226 pharmacology & pharmacy ,Likert scale ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Explicit criteria ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Potentially Inappropriate Medication List ,Aged ,Pharmacology ,Geriatrics ,Aged, 80 and over ,Clinical pharmacology ,Health professionals ,business.industry ,Age Factors ,Multimorbidity ,General Medicine ,Middle Aged ,3. Good health ,Family medicine ,Relative risk ,Older adults ,Female ,France ,business ,Inclusion (education) ,Algorithms - Abstract
International audience; Purpose To establish a consensus on both explicit and implicit criteria in order to identify potentially inappropriate prescribing (PIP) in French older people aged 75 years and over or 65 years and over with multimorbidity. Methods Fifteen experts in geriatrics, general practice, pharmacy, and clinical pharmacology were involved in a two-round Delphi survey to assess preliminary explicit and implicit criteria based on an extensive literature review and up-to-date evidence data. Experts were asked to rate their level of agreement using a 5-level Likert scale for inclusion of criteria and also for rationale and therapeutic alternatives. A consensus was considered as reached if at least 75% of the experts rated criteria as "strongly agreed" or "agreed." Results The new tool included a seven-step algorithm (implicit criteria) encompassing the three main domains that define PIP (i.e. overprescribing, underprescribing, and misprescribing) and 104 explicit criteria. Explicit criteria were divided into 6 tables related to inappropriate drug duplications (n = 7 criteria), omissions of medications and/or medication associations (n = 16), medications with an unfavourable benefit/risk ratio and/or a questionable efficacy (n = 39), medications with an unsuitable dose (n = 4) or duration (n = 6), drug-disease (n = 13), and drug-drug interactions (n = 19). Conclusion The REMEDI[e]S tool (REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors) is an original mixed tool, adapted to French medical practices, aimed at preventing PIP both at the individual level in clinical practice and the population level in large-scale studies. Therefore, its use could contribute to an improvement in healthcare professionals' prescribing practices and safer care in older adults.
- Published
- 2021