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LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care

Author

Listed:
  • Xisco Reus

    (Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain)

  • Maria Lluisa Sastre

    (Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain)

  • Alfonso Leiva

    (Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
    Balearic Health Service IbSalut, Reseach Unit Primary Care Mallorca, 07013 Palma, Spain)

  • Belén Sánchez

    (Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain)

  • Cristina García-Serra

    (Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain)

  • Ignatios Ioakeim-Skoufa

    (Department of Drug Statistics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, 0213 Oslo, Norway
    Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), 08009 Barcelona, Spain
    EpiChron Research Group, IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain)

  • Caterina Vicens

    (Balearic Health Service IbSalut Son Serra-La Vileta Healthcare Centre, 07013 Palma, Spain
    Research Network on Chronicity, Primary Care, and Health Promotion (RICAPPS), Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain
    Drug Utilization Work Group, Spanish Society of Family and Community Medicine (semFYC), 08009 Barcelona, Spain)

Abstract

Potentially inappropriate medication (PIM) increases adverse drug reactions and mortality, especially in excessively polymedicated patients. General practitioners are often in charge of this process. Some tools have been created to support them in this matter. This study aimed to measure the amount of potentially inappropriate medication among excessively polymedicated patients using several supporting tools and assess the feasibility of these tools in primary care. Several explicit deprescribing criteria were used to identify potentially inappropriate medications. The level of agreement between all the criteria and the acceptance by the general practitioner (GP) was also measured. We analysed whether the drugs proposed for deprescribing were eventually withdrawn after twelve months. The total number of drugs prescribed was 2038. Six hundred and forty-nine drugs (31.8%) were considered potentially inappropriate by at least one of the tools. GPs agreed with the tools in 56.7% of the cases. In a 12-month period, 109 drugs, representing 29.6% of the drugs that GPs agreed to deprescribe, were withdrawn. Elderly excessively polymedicated patients accumulated a great number of PIMs. The use of deprescribing supporting tools, such as explicit criteria, is feasible in primary care, and these tools are well accepted by the GPs. However, eventual withdrawal was carried out in less than half of the cases.

Suggested Citation

  • Xisco Reus & Maria Lluisa Sastre & Alfonso Leiva & Belén Sánchez & Cristina García-Serra & Ignatios Ioakeim-Skoufa & Caterina Vicens, 2022. "LESS-PHARMA Study: Identifying and Deprescribing Potentially Inappropriate Medication in the Elderly Population with Excessive Polypharmacy in Primary Care," IJERPH, MDPI, vol. 19(20), pages 1-10, October.
  • Handle: RePEc:gam:jijerp:v:19:y:2022:i:20:p:13241-:d:942306
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    References listed on IDEAS

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    1. Miguel Ángel Hernández-Rodríguez & Ermengol Sempere-Verdú & Caterina Vicens-Caldentey & Francisca González-Rubio & Félix Miguel-García & Vicente Palop-Larrea & Ramón Orueta-Sánchez & Óscar Esteban-Jim, 2021. "Drug Prescription Profiles in Patients with Polypharmacy in Spain: A Large-Scale Pharmacoepidemiologic Study Using Real-World Data," IJERPH, MDPI, vol. 18(9), pages 1-10, April.
    2. Dedan Opondo & Saied Eslami & Stefan Visscher & Sophia E de Rooij & Robert Verheij & Joke C Korevaar & Ameen Abu-Hanna, 2012. "Inappropriateness of Medication Prescriptions to Elderly Patients in the Primary Care Setting: A Systematic Review," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-9, August.
    3. Ignatios Ioakeim-Skoufa & Mercedes Clerencia-Sierra & Aida Moreno-Juste & Carmen Elías de Molins Peña & Beatriz Poblador-Plou & Mercedes Aza-Pascual-Salcedo & Francisca González-Rubio & Alexandra Prad, 2022. "Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort," IJERPH, MDPI, vol. 19(16), pages 1-15, August.
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