Rodrigues Daniela A, Herdeiro Maria T, Thürmann Petra A, Figueiras Adolfo, Coutinho Paula, Roque Fátima
Unidade de Investigação para o Desenvolvimento do Interior. Instituto Politécnico da Guarda (UDI-IPG). Guarda. Portugal.
Departamento de Ciências Médicas e Instituto de Biomedicina. Universidade de Aveiro (iBIMED-UA). Aveiro. Portugal.
Acta Med Port. 2021 Mar 1;34(3):194-200. doi: 10.20344/amp.13618. Epub 2020 Nov 23.
In 2015, the EU(7)-PIM List was published, which identifies potentially inappropriate medicines in older patients and resulted from a consensus of experts from seven European countries. Portugal was not part of this group, so it was not originally adapted to the Portuguese reality. With this work, we intend to elaborate a list of potentially inappropriate medicines adapted to the reality of medicines marketed in Portugal, through the operationalization of the EU(7)-PIM List for the national reality and to evaluate the adequacy of its use for clinical practice.
Search, in INFARMED's Infomed database, of drugs that are included in the EU(7)-PIM List that have marketing authorization, and analysis of possible new drugs for inclusion in the list. The tool adapted to the Portuguese reality was applied to a sample of 1089 outpatient, polymedicated older patients from 38 primary care units in Central Portugal.
The final PIM list adapted to the Portuguese reality includes 184 potentially inappropriate medicines (from these, 178 are active substances, five are classes of drugs, and one corresponds to the sliding scale therapeutic scheme used in insulin therapy). Of 1089 polymedicated older patients, 83.7% took at least one drug included in the final potentially inappropriate medicines list or belonging to one of the groups included in the list, and, on average, each patient took 1.74 (IQR 1 - 2).
Even though the availability of drugs on the market is quite diverse, the EU(7)-PIM List has been used in several European countries. With this study, we operationalized the European list for the Portuguese reality, which will enable its application in clinical practice.
The list drawn up is a useful tool for the identification of potentially inappropriate medicines, easy to use in clinical practice and research.
2015年，欧盟（7国）潜在不适当用药清单发布，该清单确定了老年患者中潜在不适当的药物，由七个欧洲国家的专家达成共识制定。葡萄牙不属于该专家组，因此该清单最初并未适配葡萄牙的实际情况。通过这项工作，我们打算通过将欧盟（7国）潜在不适当用药清单应用于葡萄牙国情，制定一份适合在葡萄牙上市药品实际情况的潜在不适当用药清单，并评估其在临床实践中的使用适用性。
在葡萄牙药品与健康产品管理局（INFARMED）的Infomed数据库中搜索欧盟（7国）潜在不适当用药清单中已获得上市许可的药物，并分析可能纳入该清单的新药。将适配葡萄牙实际情况的工具应用于来自葡萄牙中部38个初级保健单位的1089名多药联用的老年门诊患者样本。
适配葡萄牙实际情况的最终潜在不适当用药清单包括184种潜在不适当药物（其中178种为活性物质，5种为药物类别，1种对应胰岛素治疗中使用的滑动比例治疗方案）。在1089名多药联用的老年患者中，83.7%的患者服用了至少一种最终潜在不适当用药清单中包含的药物或属于该清单所列组别的药物之一，平均每位患者服用1.74种（四分位距1 - 2）。
尽管市场上药品种类繁多，但欧盟（7国）潜在不适当用药清单已在多个欧洲国家使用。通过本研究，我们将欧洲清单应用于葡萄牙国情，这将使其能够在临床实践中应用。
制定的清单是识别潜在不适当药物的有用工具，便于在临床实践和研究中使用。
