REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria - Individual Prediction and Prevention of Risks of Immunosuppressive Therapies in Transplantation Access content directly
Journal Articles European Journal of Clinical Pharmacology Year : 2021

REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria

Julie Berthou-Contreras
  • Function : Author
Marion Charenton-Blavignac
  • Function : Author
Jean Doucet
  • Function : Author
  • PersonId : 951112
Blandine de La Gastine
  • Function : Author
Valerie Gras
  • Function : Author
Muriel Grau
  • Function : Author
Karen Rudelle
  • Function : Author
Marie-Blanche Valnet-Rabier
  • Function : Author
Thomas Tannou

Abstract

Purpose To establish a consensus on both explicit and implicit criteria in order to identify potentially inappropriate prescribing (PIP) in French older people aged 75 years and over or 65 years and over with multimorbidity. Methods Fifteen experts in geriatrics, general practice, pharmacy, and clinical pharmacology were involved in a two-round Delphi survey to assess preliminary explicit and implicit criteria based on an extensive literature review and up-to-date evidence data. Experts were asked to rate their level of agreement using a 5-level Likert scale for inclusion of criteria and also for rationale and therapeutic alternatives. A consensus was considered as reached if at least 75% of the experts rated criteria as "strongly agreed" or "agreed." Results The new tool included a seven-step algorithm (implicit criteria) encompassing the three main domains that define PIP (i.e. overprescribing, underprescribing, and misprescribing) and 104 explicit criteria. Explicit criteria were divided into 6 tables related to inappropriate drug duplications (n = 7 criteria), omissions of medications and/or medication associations (n = 16), medications with an unfavourable benefit/risk ratio and/or a questionable efficacy (n = 39), medications with an unsuitable dose (n = 4) or duration (n = 6), drug-disease (n = 13), and drug-drug interactions (n = 19). Conclusion The REMEDI[e]S tool (REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors) is an original mixed tool, adapted to French medical practices, aimed at preventing PIP both at the individual level in clinical practice and the population level in large-scale studies. Therefore, its use could contribute to an improvement in healthcare professionals' prescribing practices and safer care in older adults.
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Dates and versions

hal-03285127 , version 1 (13-07-2021)

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Barbara Roux, Julie Berthou-Contreras, Jean-Baptiste Beuscart, Marion Charenton-Blavignac, Jean Doucet, et al.. REview of potentially inappropriate MEDIcation pr[e]scribing in Seniors (REMEDI[e]S): French implicit and explicit criteria. European Journal of Clinical Pharmacology, 2021, 77 (11), pp.1713-1724. ⟨10.1007/s00228-021-03145-6⟩. ⟨hal-03285127⟩
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