https://doi.org/10.4081/gc.2023.11597

Shaping geriatric practice: evaluating Beers, PRISCUS, and European Union(7) criteria for optimal patient care. A retrospective study

Vol. 9 No. 2 (2023)
Submitted: 20 July 2023
Accepted: 13 October 2023
Published: 23 October 2023
Beers criteria, EU(7) PIM list, geriatric, potentially inappropriate medicine, PRISCUS list
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Authors

Shikha Sood
https://orcid.org/0000-0003-2937-7031
Department of Pharmacology, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India.
Nidhi Saija
https://orcid.org/0009-0000-4248-9359
Department of Pharmacology, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India.
Devang Rana
Department of Pharmacology, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India.
Kanisha Shah
https://orcid.org/0000-0001-8581-9725
Department of Pharmacology, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India.
Hirva Santoki
Department of Pharmacology, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India.
Vipul Prajapati
santabanta123456@gmail.com
Department of Pharmacology, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujarat, India.

Medications whose risk of adverse drug events exceeds their expected clinical benefit when given to older patients are called potentially inappropriate medications (PIMs). The geriatric population represents about 10% of the world population and 7% of the Indian population and consumes 40% of prescription and 35% of all over-the-counter drugs. That is why it is necessary to evaluate the use of PIMs in the geriatric population. This study aimed to evaluate prescriptions for PIMs by using three pre-validated and internationally used criteria, namely the Beers criteria (2019), the European Union (EU)(7) list (2015), and the PRISCUS list (2010). A retrospective observational study began after obtaining written approval from the institutional review board. Demographic and clinical profiles and patients' complete prescriptions were recorded, and the Beers criteria (2019), the EU(7) (2015) list, and the PRISCUS list (2010) were applied. A p<0.05 was considered statistically significant. A total of 345 patients, with a mean age of 71.48 years, were included in the study. Vitamin D3 (56.81%) was frequently prescribed as medicine. According to the Beers, EU(7), and PRISCUS criteria, PIMs were 311 (11.26%), 272 (9.85%), and 105 (3.80%), respectively. Pantoprazole [20.57% Beers and 23.52% EU(7)] and glimepiride [15.43% Beers and 17.64% EU(7)] were the most inappropriate drugs. According to the PRISCUS list, piroxicam (21.9%) and etoricoxib (19.04%) were the inappropriate drugs. According to the Beers, EU(7), and PRISCUS criteria, total inappropriate prescriptions containing at least one PIM are 183 (52.04%), 174 (50.43%), and 88 (25.5%), respectively. The number of prescriptions with inappropriate medication is highly correlated with the total number of drugs prescribed per prescription (p<0.01) and the total number of fixed-dose combinations (p<0.01). Maximum PIMs were found with the Beers criteria and minimum PIMs with the PRISCUS list. This study shows that the prescription of PIMs ranges from 25.5 to 52.04%. The EU(7) list had the highest sensitivity (63.66%), while the PRISCUS list had the highest specificity (98.48%) to detect PIMs with the Beers criteria taken as a reference.

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Crossref
Scopus
Google Scholar
Europe PMC
Spinewine A, Schmader KE, Barber N, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet 2007;370:173-84. DOI: https://doi.org/10.1016/S0140-6736(07)61091-5
World Bank. Population ages 65 and above (% of total population); 2022. Available from: https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS. Accessed on: 13/09/2023.
Brunton LL, Hilal-Dandan R. Goodman and Gilman's the pharmacological basis of therapeutics. 13th ed. New York, USA: McGraw-Hill Education; 2018.
Andres TM, McGrane T, McEvoy MD, Allen BF. Geriatric pharmacology: an update. Anesthesiol Clin 2019;37:475-92. DOI: https://doi.org/10.1016/j.anclin.2019.04.007
Ambwani S, Misra AK, Midha NK, et al. A prospective, cross-sectional study on prescribing pattern of drugs and the incidence of potentially inappropriate medications in geriatrics population at a tertiary care teaching hospital in western India. Asia Pac J Med Toxicol 2020;9:136-41. DOI: https://doi.org/10.4103/jfmpc.jfmpc_872_19
Llor C, Bjerrum L. Antimicrobial resistance: risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf 2014;5:229-41. DOI: https://doi.org/10.1177/2042098614554919
National Institute for Clinical Excellence. Principles for best practice in clinical audit. Oxon, UK: Radcliffe Publishing; 2012.
O’Connor MN, Gallagher P, O’Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging 2012;29:437-52. DOI: https://doi.org/10.2165/11632610-000000000-00000
Lisowska A, Czepielewska E, Rydz M, et al. Applicability of tools to identify potentially inappropriate prescribing in elderly during medication review: comparison of STOPP/START version 2, Beers 2019, EU(7)-PIM list, PRISCUS list, and Amsterdam tool - a pilot study. PLoS One 17:e0275456. DOI: https://doi.org/10.1371/journal.pone.0275456
American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American geriatrics society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012;60:616-31. DOI: https://doi.org/10.1111/j.1532-5415.2012.03923.x
Renom-Guiteras A, Meyer G, Thürmann PA. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol 2015;71:861-75. DOI: https://doi.org/10.1007/s00228-015-1860-9
Krüger C, Schäfer I, van den Bussche H, et al. Comparison of FORTA, PRISCUS and EU(7)-PIM lists on identifying potentially inappropriate medication and its impact on cognitive function in multimorbid elderly German people in primary care: a multicentre observational study. BMJ Open 2021;11:e050344. DOI: https://doi.org/10.1136/bmjopen-2021-050344
Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 2010;107:543-51. DOI: https://doi.org/10.3238/arztebl.2010.0543
2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American geriatrics society 2019 updated AGS Beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2019;67:674-94. DOI: https://doi.org/10.1111/jgs.15767
Grina D, Briedis V. The use of potentially inappropriate medications among the Lithuanian elderly according to Beers and EU(7)‐PIM list - a nationwide cross‐sectional study on reimbursement claims data. J Clin Pharm Ther 2017;42:195-200. DOI: https://doi.org/10.1111/jcpt.12494

How to Cite

Sood, S., Saija, N., Rana, D., Shah, K., Santoki, H., & Prajapati, V. (2023). Shaping geriatric practice: evaluating Beers, PRISCUS, and European Union(7) criteria for optimal patient care. A retrospective study. Geriatric Care, 9(2). https://doi.org/10.4081/gc.2023.11597
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