Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Network Aging Research, University of Heidelberg, Heidelberg, Germany.
Pain Med. 2021 Sep 8;22(9):1962-1969. doi: 10.1093/pm/pnaa480.
To compare the prevalence of potentially inappropriate non-steroidal anti-inflammatory drugs (NSAIDs) among NSAIDs users defined with frequently used potentially inappropriate medication (PIM) lists and to identify the determinants of their use.
Cross-sectional survey among community-dwelling older adults from Germany.
N = 284 NSAIDs users aged 65-89 years.
All currently regularly or as-needed used drugs were recorded during a home visit. Multivariate logistic regression models were applied to assess the potential determinants of potentially inappropriate NSAIDs use.
Prevalence of potentially inappropriate NSAIDs use was 54.2%, 45.4%, 29.9%, 20.4%, and 3.5% when applying the STOPP, 2019 Beers, EU(7)-PIM, FORTA, and PRISCUS list, respectively. No study participant was identified as a potentially inappropriate NSAIDs user by all five lists simultaneously. The majority (68%) were identified only by one or two lists. Merely the STOPP and Beers criteria had a moderate inter-instrument agreement. Lower pain severity, gout, peptic ulcer (PU), cardiovascular disease (CVD), and chronic kidney disease (CKD) were statistically significantly associated with potentially inappropriate NSAIDs use defined by the STOPP criteria and the latter three conditions also with the 2019 Beers criteria.
The STOPP and Beers criteria may be superior to the other lists because they more frequently identify potentially inappropriate NSAIDs use in conditions implying a high risk for NSAIDs' adverse events (i.e., PUD, CKD and CVD). We developed a harmonized, country-independent PIM list for NSAIDs with the same advantages as observed for the STOOP and 2019 Beers criteria and recommended its use.
比较使用常用潜在不适当药物（PIM）清单定义的 NSAIDs 使用者中潜在不适当非甾体抗炎药（NSAIDs）的流行率，并确定其使用的决定因素。
德国社区居住的老年人群体的横断面调查。
284 名年龄在 65-89 岁的 NSAIDs 使用者。
在家庭访问期间记录所有当前定期或按需使用的药物。应用多变量逻辑回归模型评估潜在不适当 NSAIDs 使用的潜在决定因素。
当应用 STOPP、2019 年 Beers、EU(7)-PIM、FORTA 和 PRISCUS 清单时，潜在不适当 NSAIDs 使用的患病率分别为 54.2%、45.4%、29.9%、20.4%和 3.5%。没有研究参与者同时被所有五个清单确定为潜在不适当的 NSAIDs 使用者。大多数（68%）仅被一个或两个清单确定。只有 STOPP 和 Beers 标准具有中等的仪器间一致性。较低的疼痛严重程度、痛风、消化性溃疡（PU）、心血管疾病（CVD）和慢性肾病（CKD）与 STOPP 标准定义的潜在不适当 NSAIDs 使用以及后三种情况与 2019 年 Beers 标准均有统计学显著关联。
STOPP 和 Beers 标准可能优于其他清单，因为它们在涉及 NSAIDs 不良反应高风险的情况下（即 PUD、CKD 和 CVD）更频繁地确定潜在不适当的 NSAIDs 使用。我们开发了一种具有与 STOPP 和 2019 年 Beers 标准相同优势的、适用于 NSAIDs 的国家独立 PIM 清单，并建议使用该清单。
