Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study

Journal of Pharmaceutical Policy and Practice

Research

Maw Pin Tan¹  Philip Rajan²  HS Arvinder-Singh³  Alan Swee Hock Ch’ng⁴  Muhammad Radzi Abu Hassan⁵  Huan Keat Chan⁶  Jun How Ooi⁷  Chiann Ni Thiam⁸  Wee Kooi Cheah⁹  Chern Choong Thum^1,10  Wai Mun Chung^1,11  Kar Choon Tan^1,12  Subashini Ambigapathy^1,13  Paranthaman Vengadasalam^1,14  Weng Keong Yau^1,15  Nor Azlina Abu Bakar^1,16  Hooi Peng Lee^1,17  Muhammad Azuan Azman^1,18  Siti Mallissa Mohd Shariff^1,19  Noor Hamizah Sabki^2,20  Surina Zaman Huri^2,21  Shaun Wen Huey Lee^2,22  Siew Li Teoh^2,22  Chee Tao Chang^2,23 

[1] Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia;Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Petaling Jaya, Malaysia;Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia;Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia;Department of Community Medicine, Hospital University Kebangsaan Malaysia, Bangi, Malaysia;Clinical Research Centre, Hospital Seberang Jaya, Ministry of Health Malaysia, Seberang Jaya, Malaysia;Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia;Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia;Clinical Research Centre, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia;Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia;Department of Medicine, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Malaysia;Department of Medicine, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia;Department of Psychiatry, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang, Malaysia;Emergency and Trauma Department, Hospital Taiping, Taiping, Malaysia;Hepatological Department, Hospital Selayang, Ministry of Health Malaysia, Selayang, Malaysia;Klinik Kesihatan Buntong, Ministry of Health Malaysia, Ipoh, Malaysia;Klinik Kesihatan Greentown, Ministry of Health Malaysia, Ipoh, Malaysia;Medical Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia;Medical Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia;Pharmacy Department, Hospital Kuala Lumpur, Ministry of Health Malaysia, Kuala Lumpur, Malaysia;Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia;Pharmacy Department, Hospital Sungai Buloh, Ministry of Health Malaysia, Sungai Buloh, Malaysia;Pharmacy Department, Hospital Taiping, Ministry of Health Malaysia, Taiping, Malaysia;Psychiatry Department, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia;School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia;School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia;Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Malaysia;

关键词: Polypharmacy;    Potentially inappropriate medications;    Older adults;    Medication review;    Prescribing omission;   

DOI  :  10.1186/s40545-023-00630-4

 received in 2023-07-04, accepted in 2023-10-03,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionPolypharmacy and potentially inappropriate medications (PIM) are common among older adults. To guide appropriate prescribing, healthcare professionals often rely on explicit criteria to identify and deprescribe inappropriate medications, or to start medications due to prescribing omission. However, most explicit PIM criteria were developed with inadequate guidance from quality metrics or integrating real-world data, which are rich and valuable data source.AimTo develop a list of medications to facilitate appropriate prescribing among older adults.MethodsA preliminary list of PIM and potential prescribing omission (PPO) were generated from systematic review, supplemented with local pharmacovigilance data of adverse reaction incidents among older people. Twenty-one experts from nine specialties participated in two Delphi to determine the list of PIM and PPO in February and March 2023. Items that did not reach consensus after the second Delphi round were adjudicated by six geriatricians.ResultsThe preliminary list included 406 potential candidates, categorised into three sections: PIM independent of diseases, disease dependent PIM and omitted drugs that could be restarted. At the end of Delphi, 92 items were decided as PIM, including medication classes, such as antacids, laxatives, antithrombotics, antihypertensives, hormones, analgesics, antipsychotics, antidepressants, and antihistamines. Forty-two disease-specific PIM criteria were included, covering circulatory system, nervous system, gastrointestinal system, genitourinary system, and respiratory system. Consensus to start potentially omitted treatment was achieved in 35 statements across nine domains.ConclusionsThe newly developed PIM criteria can serve as a useful tool to guide clinicians and pharmacists in identifying PIMs and PPOs during medication review and facilitating informed decision-making for appropriate prescribing.

【 授权许可】

CC BY   
© Dr. Zaheer-Ud-Din Babar and Auckland UniServices Ltd. 2023

【 图 表 】

Fig. 6

12951_2015_155_Article_IEq23.gif