Sciences and Health Technologies Program, University of Brasilia, Brasilia, DF, Brazil.
Physical Education, University UNIEURO, Brasilia, DF, Brazil.
Clin Interv Aging. 2022 Feb 16;17:151-161. doi: 10.2147/CIA.S318578. eCollection 2022.
The use of potentially inappropriate medications (PIM) can impair the safety and effectiveness of pharmacotherapy in the older adults. Thus, several countries have lists and criteria to indicate these drugs, in order to promote the safety of prescription and the rational use of drugs in geriatric practice.
This study sought to contribute to the inclusion of PIM for the older adults in the Brazilian criterion (BCPIM/2016) - current list used in Brazil and reference in Latin American countries - through expert approval, comparing convergences with international AGS lists BEERS/2019, STOPP/START/2015, PRISCUS/2010 and EU (7)-PIM List/2015.
This is a critical analysis of potentially inappropriate medications for use in the older adults present in the list of Brazilian criteria, together with their absence of some drugs that are on international lists (BEERS/2019; Priscus/2010; Stopp/Start/2015; EU7-PIM list/2015). This study was subdivided in 6 stages: selection of national criteria, classification of drugs according to Anatomic Therapeutic Chemical, comparison between BCPIM/2016 with international lists, selection of drugs not included in the Brazilian list, selection of experts for evaluation and suggestions about drugs not included in the Brazilian list and the synthesis of the analysis carried out by the specialists.
We cataloged 66 drugs marketed in Brazil that are on international lists, but not in the Brazilian consensus, of which 24 were validated by experts as necessary for inclusion in this consensus, considering the risks and benefits in health care for the older adults. However, the lists have divergences and similarities between them. We observed that eight drugs were common to all criteria studied, mainly related to the nervous system.
The results suggest the need for periodic validation of PIM against research clinics, new drugs and the inclusion of this agenda by the Ministry of Health in the revision of the National List of Essential Drugs and other Clinical Protocols and Therapeutic Prescription Guidelines for the older adults.
不适当用药（PIM）的使用会影响老年患者药物治疗的安全性和有效性。因此，许多国家都制定了相关的药物清单和标准来指出这些药物，以促进处方安全和老年患者合理用药。
本研究旨在通过专家认可，将老年人潜在不适当用药（PIM）纳入巴西标准（BCPIM/2016）-巴西目前使用的清单，并作为拉丁美洲国家的参考，同时与国际 AGS 清单 BEERS/2019、STOPP/START/2015、PRISCUS/2010 和欧盟（7）-PIM 清单/2015 进行比较，以寻找共识。
本研究对巴西标准清单中存在的老年人潜在不适当用药进行了批判性分析，并对国际清单（BEERS/2019；Priscus/2010；Stopp/Start/2015；EU7-PIM 清单/2015）中未包含的一些药物进行了分析。本研究分为 6 个阶段：选择国家标准、根据解剖治疗化学分类药物、比较 BCPIM/2016 与国际清单、选择巴西清单未包含的药物、选择评估专家和对巴西清单未包含的药物提出建议以及综合专家分析。
我们将巴西市场上的 66 种国际清单上的药物列入目录，但巴西共识中没有这些药物，其中 24 种药物经专家验证认为有必要纳入该共识，以考虑老年人的健康风险和收益。然而，这些清单之间存在差异和相似之处。我们发现，所有研究标准都有 8 种药物是共同的，主要与神经系统有关。
研究结果表明，有必要定期根据研究诊所、新药和卫生部门的建议对 PIM 进行验证，将这一议程纳入国家基本药物清单和其他老年人临床方案及治疗处方指南的修订。
