Detecting Medication Risks among People in Need of Care: Performance of Six Instruments.

Autor:	Dreischulte T; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany., Sanftenberg L; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany., Hennigs P; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany., Zöllinger I; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany., Schwaiger R; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany., Floto C; Institute of General Practice, Friedrich-Alexander-University of Erlangen-Nuremberg, 91054 Erlangen, Germany., Sebastiao M; Institute of General Practice, Friedrich-Alexander-University of Erlangen-Nuremberg, 91054 Erlangen, Germany., Kühlein T; Institute of General Practice, Friedrich-Alexander-University of Erlangen-Nuremberg, 91054 Erlangen, Germany., Hindenburg D; Institute of General Practice, University Hospital of Julius-Maximilians-Universität Würzburg, 97070 Würzburg, Germany., Gagyor I; Institute of General Practice, University Hospital of Julius-Maximilians-Universität Würzburg, 97070 Würzburg, Germany., Wildgruber D; Katholische Stiftungshochschule München/University of Applied Sciences, 81667 Munich, Germany., Hausen A; Katholische Stiftungshochschule München/University of Applied Sciences, 81667 Munich, Germany., Janke C; Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of LMU Munich, 80802 Munich, Germany., Hölscher M; Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of LMU Munich, 80802 Munich, Germany., Teupser D; Institute of Laboratory Medicine, University Hospital of LMU Munich, 81377 Munich, Germany., Gensichen J; Institute of General Practice and Family Medicine, University Hospital, LMU Munich, 80336 Munich, Germany., On Behalf Of The Bacom Study Group
Jazyk:	angličtina
Zdroj:	International journal of environmental research and public health [Int J Environ Res Public Health] 2023 Jan 28; Vol. 20 (3). Date of Electronic Publication: 2023 Jan 28.
DOI:	10.3390/ijerph20032327
Abstrakt:	Introduction: Numerous tools exist to detect potentially inappropriate medication (PIM) and potential prescribing omissions (PPO) in older people, but it remains unclear which tools may be most relevant in which setting. Objectives: This cross sectional study compares six validated tools in terms of PIM and PPO detection. Methods: We examined the PIM/PPO prevalence for all tools combined and the sensitivity of each tool. The pairwise agreement between tools was determined using Cohen's Kappa. Results: We included 226 patients in need of care (median (IQR age 84 (80-89)). The overall PIM prevalence was 91.6 (95% CI, 87.2-94.9)% and the overall PPO prevalence was 63.7 (57.1-69.9%)%. The detected PIM prevalence ranged from 76.5%, for FORTA-C/D, to 6.6% for anticholinergic drugs (German-ACB). The PPO prevalences for START (63.7%) and FORTA-A (62.8%) were similar. The pairwise agreement between tools was poor to moderate. The sensitivity of PIM detection was highest for FORTA-C/D (55.1%), and increased to 79.2% when distinct items from STOPP were added. Conclusion: Using a single screening tool may not have sufficient sensitivity to detect PIMs and PPOs. Further research is required to optimize the composition of PIM and PPO tools in different settings.
Databáze:	MEDLINE
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