Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Br J Clin Pharmacol. 2011 Sep;72(3):482-9. doi: 10.1111/j.1365-2125.2011.04010.x.
Our aim was to compare the practicability of six different potentially inappropriate medication (PIM) criteria in geriatric outpatients with polypharmacy.
We analysed baseline data from the Medication Safety Review Clinic in Taiwanese Elders (MSRC-Taiwan) study. The prevalence and correlates of PIMs were determined on the basis of criteria developed in the USA, Canada, France, Norway, Ireland and Thailand. The percentage of PIMs considered as drug-related problems and the problem-solving rate are reported.
In the 193 participants, the prevalence of PIM varied from 24 to 73%. Application of the criteria revealed that a high number of chronic medications was a common risk factor for having at least one PIM. Of the 1713 medications reviewed, 5.6-14.8% were considered PIMs. Only 30-40% of the identified PIMs were reported as drug-related problems by the MSRC team experts. Criteria with a higher number of statements and a higher percentage of local market/institution drug availability tended to detect more PIMs.
The prevalence of PIM varied significantly when different criteria were applied. Caution should be exercised in applying PIM criteria developed in other regions when medication availability in the local market is limited.
本研究旨在比较 6 种不同潜在不适当药物（PIM）标准在老年多病患者中的实用性。
我们分析了来自台湾老年人药物安全审查诊所（MSRC-Taiwan）研究的基线数据。根据美国、加拿大、法国、挪威、爱尔兰和泰国制定的标准，确定了 PIM 的患病率及其相关因素。报告了被认为与药物相关的问题的 PIM 百分比和解决问题的比率。
在 193 名参与者中，PIM 的患病率从 24%到 73%不等。应用这些标准表明，长期使用大量药物是存在至少一种 PIM 的常见危险因素。在审查的 1713 种药物中，5.6%-14.8%被认为是 PIM。由 MSRC 团队专家报告的被识别出的 PIM 中，仅有 30%-40%被认为是与药物相关的问题。具有更多陈述和更高比例的当地市场/机构药物可获得性的标准往往会检测到更多的 PIM。
当应用不同的标准时，PIM 的患病率差异显著。在当地市场药物供应有限的情况下，应用其他地区制定的 PIM 标准时应谨慎。
