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

INTRODUCTION: Polypharmacy 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 omiss...

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Autores principales: Chang, Chee Tao, Chan, Huan Keat, Cheah, Wee Kooi, Tan, Maw Pin, Ch’ng, Alan Swee Hock, Thiam, Chiann Ni, Abu Bakar, Nor Azlina, Yau, Weng Keong, Abu Hassan, Muhammad Radzi, Rajan, Philip, Tan, Kar Choon, Ambigapathy, Subashini, Vengadasalam, Paranthaman, Zaman Huri, Surina, Arvinder-Singh, HS, Thum, Chern Choong, Chung, Wai Mun, Ooi, Jun How, Sabki, Noor Hamizah, Lee, Hooi Peng, Mohd Shariff, Siti Mallissa, Azman, Muhammad Azuan, Teoh, Siew Li, Lee, Shaun Wen Huey
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588247/
https://www.ncbi.nlm.nih.gov/pubmed/37858273
http://dx.doi.org/10.1186/s40545-023-00630-4
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author Chang, Chee Tao
Chan, Huan Keat
Cheah, Wee Kooi
Tan, Maw Pin
Ch’ng, Alan Swee Hock
Thiam, Chiann Ni
Abu Bakar, Nor Azlina
Yau, Weng Keong
Abu Hassan, Muhammad Radzi
Rajan, Philip
Tan, Kar Choon
Ambigapathy, Subashini
Vengadasalam, Paranthaman
Zaman Huri, Surina
Arvinder-Singh, HS
Thum, Chern Choong
Chung, Wai Mun
Ooi, Jun How
Sabki, Noor Hamizah
Lee, Hooi Peng
Mohd Shariff, Siti Mallissa
Azman, Muhammad Azuan
Teoh, Siew Li
Lee, Shaun Wen Huey
author_facet Chang, Chee Tao
Chan, Huan Keat
Cheah, Wee Kooi
Tan, Maw Pin
Ch’ng, Alan Swee Hock
Thiam, Chiann Ni
Abu Bakar, Nor Azlina
Yau, Weng Keong
Abu Hassan, Muhammad Radzi
Rajan, Philip
Tan, Kar Choon
Ambigapathy, Subashini
Vengadasalam, Paranthaman
Zaman Huri, Surina
Arvinder-Singh, HS
Thum, Chern Choong
Chung, Wai Mun
Ooi, Jun How
Sabki, Noor Hamizah
Lee, Hooi Peng
Mohd Shariff, Siti Mallissa
Azman, Muhammad Azuan
Teoh, Siew Li
Lee, Shaun Wen Huey
author_sort Chang, Chee Tao
collection PubMed
description INTRODUCTION: Polypharmacy 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. AIM: To develop a list of medications to facilitate appropriate prescribing among older adults. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: The 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40545-023-00630-4.
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spelling pubmed-105882472023-10-21 Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study Chang, Chee Tao Chan, Huan Keat Cheah, Wee Kooi Tan, Maw Pin Ch’ng, Alan Swee Hock Thiam, Chiann Ni Abu Bakar, Nor Azlina Yau, Weng Keong Abu Hassan, Muhammad Radzi Rajan, Philip Tan, Kar Choon Ambigapathy, Subashini Vengadasalam, Paranthaman Zaman Huri, Surina Arvinder-Singh, HS Thum, Chern Choong Chung, Wai Mun Ooi, Jun How Sabki, Noor Hamizah Lee, Hooi Peng Mohd Shariff, Siti Mallissa Azman, Muhammad Azuan Teoh, Siew Li Lee, Shaun Wen Huey J Pharm Policy Pract Research INTRODUCTION: Polypharmacy 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. AIM: To develop a list of medications to facilitate appropriate prescribing among older adults. METHODS: A 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. RESULTS: The 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. CONCLUSIONS: The 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40545-023-00630-4. BioMed Central 2023-10-19 /pmc/articles/PMC10588247/ /pubmed/37858273 http://dx.doi.org/10.1186/s40545-023-00630-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Chang, Chee Tao
Chan, Huan Keat
Cheah, Wee Kooi
Tan, Maw Pin
Ch’ng, Alan Swee Hock
Thiam, Chiann Ni
Abu Bakar, Nor Azlina
Yau, Weng Keong
Abu Hassan, Muhammad Radzi
Rajan, Philip
Tan, Kar Choon
Ambigapathy, Subashini
Vengadasalam, Paranthaman
Zaman Huri, Surina
Arvinder-Singh, HS
Thum, Chern Choong
Chung, Wai Mun
Ooi, Jun How
Sabki, Noor Hamizah
Lee, Hooi Peng
Mohd Shariff, Siti Mallissa
Azman, Muhammad Azuan
Teoh, Siew Li
Lee, Shaun Wen Huey
Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study
title Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study
title_full Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study
title_fullStr Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study
title_full_unstemmed Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study
title_short Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study
title_sort development of a malaysian potentially inappropriate prescribing screening tool in older adults (malpip): a delphi study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588247/
https://www.ncbi.nlm.nih.gov/pubmed/37858273
http://dx.doi.org/10.1186/s40545-023-00630-4
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