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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
OBJECTIVES: Our study aimed to assess the frequency of potentially inappropriate medication (PIM) use (according to three PIM lists) and to examine the association between PIM use and cognitive function among participants in the MultiCare cohort. DESIGN: MultiCare is conducted as a longitudinal, mul...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451296/ https://www.ncbi.nlm.nih.gov/pubmed/34535481 http://dx.doi.org/10.1136/bmjopen-2021-050344 |
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author | Krüger, Caroline Schäfer, Ingmar van den Bussche, Hendrik Bickel, Horst Dreischulte, Tobias Fuchs, Angela König, Hans-Helmut Maier, Wolfgang Mergenthal, Karola Riedel-Heller, Steffi G Schön, Gerhard Weyerer, Siegfried Wiese, Birgitt von Renteln-Kruse, Wolfgang Langebrake, Claudia Scherer, Martin |
author_facet | Krüger, Caroline Schäfer, Ingmar van den Bussche, Hendrik Bickel, Horst Dreischulte, Tobias Fuchs, Angela König, Hans-Helmut Maier, Wolfgang Mergenthal, Karola Riedel-Heller, Steffi G Schön, Gerhard Weyerer, Siegfried Wiese, Birgitt von Renteln-Kruse, Wolfgang Langebrake, Claudia Scherer, Martin |
author_sort | Krüger, Caroline |
collection | PubMed |
description | OBJECTIVES: Our study aimed to assess the frequency of potentially inappropriate medication (PIM) use (according to three PIM lists) and to examine the association between PIM use and cognitive function among participants in the MultiCare cohort. DESIGN: MultiCare is conducted as a longitudinal, multicentre, observational cohort study. SETTING: The MultiCare study is located in eight different study centres in Germany. PARTICIPANTS: 3189 patients (59.3% female). PRIMARY AND SECONDARY OUTCOME MEASURES: The study had a cross-sectional design using baseline data from the German MultiCare study. Prescribed and over-the-counter drugs were classified using FORTA (Fit fOR The Aged), PRISCUS (Latin for ‘time-honoured’) and EU(7)-PIM lists. A mixed-effect multivariate linear regression was performed to calculate the association between PIM use patients’ cognitive function (measured with (LDST)). RESULTS: Patients (3189) used 2152 FORTA PIM (mean 0.9±1.03 per patient), 936 PRISCUS PIM (0.3±0.58) and 4311 EU(7)-PIM (1.4±1.29). The most common FORTA PIM was phenprocoumon (13.8%); the most prevalent PRISCUS PIM was amitriptyline (2.8%); the most common EU(7)-PIM was omeprazole (14.0%). The lists rate PIM differently, with an overall overlap of 6.6%. Increasing use of PIM is significantly associated with reduced cognitive function that was detected with a correlation coefficient of −0.60 for FORTA PIM (p=0.002), −0.72 for PRISCUS PIM (p=0.025) and −0.44 for EU(7)-PIM (p=0.005). CONCLUSION: We identified PIM using FORTA, PRISCUS and EU(7)-PIM lists differently and found that PIM use is associated with cognitive impairment according to LDST, whereby the FORTA list best explained cognitive decline for the German population. These findings are consistent with a negative impact of PIM use on multimorbid elderly patient outcomes. TRIAL REGISTRATION NUMBER: ISRCTN89818205. |
format | Online Article Text |
id | pubmed-8451296 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84512962021-10-05 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 Krüger, Caroline Schäfer, Ingmar van den Bussche, Hendrik Bickel, Horst Dreischulte, Tobias Fuchs, Angela König, Hans-Helmut Maier, Wolfgang Mergenthal, Karola Riedel-Heller, Steffi G Schön, Gerhard Weyerer, Siegfried Wiese, Birgitt von Renteln-Kruse, Wolfgang Langebrake, Claudia Scherer, Martin BMJ Open Geriatric Medicine OBJECTIVES: Our study aimed to assess the frequency of potentially inappropriate medication (PIM) use (according to three PIM lists) and to examine the association between PIM use and cognitive function among participants in the MultiCare cohort. DESIGN: MultiCare is conducted as a longitudinal, multicentre, observational cohort study. SETTING: The MultiCare study is located in eight different study centres in Germany. PARTICIPANTS: 3189 patients (59.3% female). PRIMARY AND SECONDARY OUTCOME MEASURES: The study had a cross-sectional design using baseline data from the German MultiCare study. Prescribed and over-the-counter drugs were classified using FORTA (Fit fOR The Aged), PRISCUS (Latin for ‘time-honoured’) and EU(7)-PIM lists. A mixed-effect multivariate linear regression was performed to calculate the association between PIM use patients’ cognitive function (measured with (LDST)). RESULTS: Patients (3189) used 2152 FORTA PIM (mean 0.9±1.03 per patient), 936 PRISCUS PIM (0.3±0.58) and 4311 EU(7)-PIM (1.4±1.29). The most common FORTA PIM was phenprocoumon (13.8%); the most prevalent PRISCUS PIM was amitriptyline (2.8%); the most common EU(7)-PIM was omeprazole (14.0%). The lists rate PIM differently, with an overall overlap of 6.6%. Increasing use of PIM is significantly associated with reduced cognitive function that was detected with a correlation coefficient of −0.60 for FORTA PIM (p=0.002), −0.72 for PRISCUS PIM (p=0.025) and −0.44 for EU(7)-PIM (p=0.005). CONCLUSION: We identified PIM using FORTA, PRISCUS and EU(7)-PIM lists differently and found that PIM use is associated with cognitive impairment according to LDST, whereby the FORTA list best explained cognitive decline for the German population. These findings are consistent with a negative impact of PIM use on multimorbid elderly patient outcomes. TRIAL REGISTRATION NUMBER: ISRCTN89818205. BMJ Publishing Group 2021-09-16 /pmc/articles/PMC8451296/ /pubmed/34535481 http://dx.doi.org/10.1136/bmjopen-2021-050344 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Geriatric Medicine Krüger, Caroline Schäfer, Ingmar van den Bussche, Hendrik Bickel, Horst Dreischulte, Tobias Fuchs, Angela König, Hans-Helmut Maier, Wolfgang Mergenthal, Karola Riedel-Heller, Steffi G Schön, Gerhard Weyerer, Siegfried Wiese, Birgitt von Renteln-Kruse, Wolfgang Langebrake, Claudia Scherer, Martin 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Geriatric Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451296/ https://www.ncbi.nlm.nih.gov/pubmed/34535481 http://dx.doi.org/10.1136/bmjopen-2021-050344 |
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