Choo Alex
Geriatric Unit, Northern Adelaide Local Health Network.
Adelaide Medical School, University of Adelaide.
Aust Prescr. 2025 Aug;48(4):128-132. doi: 10.18773/austprescr.2025.030.
Older people, especially with multimorbidity and polypharmacy, are at higher risk of adverse medication outcomes compared with younger adults. To guide safer prescribing for older people, several lists of 'potentially inappropriate medicines' (PIMs lists) have been developed. Prominent PIMs lists include the Beers Criteria (USA) and the Screening Tool of Older People's Prescriptions (STOPP) (Europe). A new Australian PIMs list was published in 2024. PIMs are medicines for which there is evidence or consensus expert opinion that the potential risks usually outweigh the clinical benefits in a specific patient cohort. The Australian PIMs list outlines medicines that should be avoided in all older people, and medicines that should be avoided in certain clinical contexts. It also provides guidance on potentially safer alternatives to the listed medicines. Importantly, medicines included in PIMs lists are not always inappropriate. There may be clinical scenarios where a PIM is appropriate for an individual patient (hence the term ). Prescribing decisions should always be individualised, considering the patient's clinical status and goals of care.
与年轻人相比,老年人,尤其是患有多种疾病且服用多种药物的老年人,出现药物不良后果的风险更高。为指导老年人更安全地用药,已制定了几份“潜在不适当药物”(PIMs清单)。著名的PIMs清单包括美国的《比尔斯标准》和欧洲的《老年人处方筛查工具》(STOPP)。2024年发布了一份新的澳大利亚PIMs清单。PIMs是指有证据或专家共识认为,在特定患者群体中,其潜在风险通常超过临床益处的药物。澳大利亚PIMs清单列出了所有老年人应避免使用的药物,以及在某些临床情况下应避免使用的药物。它还为清单上列出的药物提供了潜在更安全替代品的指导。重要的是,PIMs清单中的药物并不总是不适当的。可能存在PIMs适用于个别患者的临床情况(因此有了这个术语)。处方决策应始终个体化,考虑患者的临床状况和护理目标。