Evidence map›Paper›PMID 20827352›Full record

ArticleDeutsches Arzteblatt international2010

Potentially inappropriate medications in the elderly: the PRISCUS list.

Stefanie Holt, Sven Schmiedl, Petra A Thürmann

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Deutsches Arzteblatt international, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03903484 (A Collaborative Intervention for Streamlining Medication Appropriateness and Deprescribing Within Integrated Health-Care Teams), which is not on this map. Cited by 436 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
436citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03903484 nacompletednot on this mapstarted 2019, after this paper: background citation

A Collaborative Intervention for Streamlining Medication Appropriateness and Deprescribing Within Integrated Health-Care Teams

TypeinterventionalSponsorNova Scotia Health AuthorityRan2019 to 2022Enrolled7ConditionsInappropriate Prescribing, Primary Health Care, PolypharmacyArmsDeprescribing toolbox and intervention
3 · Its place in the literature

Who cites it

436 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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376 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Stefanie HoltKlinische Pharmakologie, Private Universität Witten/Herdecke gGmbH, Wuppertal, Germany.
Sven Schmiedl
Petra A Thürmann

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCertain drugs are classified as potentially inappropriate medications (PIM) for the elderly because they carry an increased risk of adverse drug events in this patient group. PIM lists from other countries are of limited usefulness in Germany because different drugs are on the market in each country and prescribing practices vary as well. Thus, a list of potentially inappropriate medications for the elderly was developed specifically for use in Germany.

methodsA preliminary PIM list suitable for the German market was created on the basis of a selective literature search and a qualitative analysis of published international PIM lists. The final German PIM list was developed by means of a comprehensive, structured expert survey in two rounds (a so-called Delphi process).

results83 drugs in a total of 18 drug classes were rated as potentially inappropriate for elderly patients. For 46 drugs, the experts came to no clear decision after the second Delphi round. For cases in which the administration of a PIM is clinically necessary, the final PRISCUS list contains recommendations for clinical practice, e.g. monitoring of laboratory values and dose adaptation. Therapeutic alternatives are also listed.

conclusionPotentially inappropriate medications carry the risk of causing adverse drug events in the elderly. A drawback of using a Delphi process to generate a PIM list, as was done for the new German list, is that little scientific evidence is currently available for the evaluation of active substances, potential therapeutic alternatives, and indicated monitoring procedures. Thus, the validity and practicability of the PRISCUS list remain to be demonstrated (and the same holds for PIM lists already published in other countries). It should be used as a component of an overall concept for geriatric pharmacotherapy in which polypharmacy and interacting medications are avoided, and doses are regularly re-evaluated.

Indexed as

Aged, 80 and overGeriatricsGermanyHumansInappropriate PrescribingPrescriptionsQuality Assurance, Health Care

Identifiers

PMID20827352
PMCPMC2933536

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.