Faculty of Medicine and Health Technology, Clinical Medicine, Tampere University, Tampere, Finland.
Development and Information Services, Finnish Medicines Agency, Tampere, Finland.
BMC Geriatr. 2023 Mar 10;23(1):139. doi: 10.1186/s12877-022-03706-z.
There are several national and international criteria available for identifying potentially inappropriate medications (PIMs) for older people. The prevalence of PIM use may vary depending on the criteria used. The aim is to examine the prevalence of potentially inappropriate medication use in Finland according to the Meds75+ database, developed to support clinical decision-making in Finland, and to compare it with eight other PIM criteria.
This nationwide register study consisted of Finnish people aged 75 years or older (n = 497,663) who during 2017-2019 purchased at least one prescribed medicine considered as a PIM, based on any of the included criteria. The data on purchased prescription medicines was collected from the Prescription Centre of Finland.
The annual prevalence of 10.7-57.0% was observed for PIM use depending on which criteria was used. The highest prevalence was detected with the Beers and lowest with the Laroche criteria. According to the Meds75+ database, annually every third person had used PIMs. Regardless of the applied criteria, the prevalence of PIM use decreased during the follow-up. The differences in the prevalence of medicine classes of PIMs explain the variance of the overall prevalence between the criteria, but they identify the most commonly used PIMs quite similarly.
PIM use is common among older people in Finland according to the national Meds75+ database, but the prevalence is dependent on the applied criteria. The results indicate that different PIM criteria emphasize different medicine classes, and clinicians should consider this issue when applying PIM criteria in their daily practice.
有几种国家和国际标准可用于确定老年人潜在不适当的药物(PIMs)。PIM 使用的流行率可能因使用的标准而异。目的是根据芬兰开发的 Meds75+数据库,检查芬兰潜在不适当药物使用的流行率,该数据库旨在支持芬兰的临床决策,并将其与其他八种 PIM 标准进行比较。
这项全国性的登记研究包括年龄在 75 岁或以上的芬兰人(n=497663),他们在 2017-2019 年期间至少购买了一种被认为是 PIM 的处方药物,这是基于包括的任何标准。购买的处方药数据是从芬兰处方中心收集的。
根据使用的标准,PIM 使用的年流行率为 10.7-57.0%。使用 Beers 标准时发现的流行率最高,使用 Laroche 标准时发现的流行率最低。根据 Meds75+数据库,每年每三个人就会使用 PIMs。无论应用何种标准,PIM 使用的流行率在随访期间都有所下降。PIM 药物类别的流行率差异解释了标准之间总体流行率的差异,但它们相当相似地确定了最常用的 PIMs。
根据芬兰国家 Meds75+数据库,PIM 在芬兰老年人中很常见,但流行率取决于应用的标准。结果表明,不同的 PIM 标准强调不同的药物类别,临床医生在日常实践中应用 PIM 标准时应考虑到这一点。