Consensus Validated List of Potentially Inappropriate Medication for the Elderly and Their Prevalence in South Korea

Abstract

Summary Background The aims of this study were to generate a comprehensive potentially inappropriate medication (PIM) list applicable for Korean elderly based on the international PIM lists (Beers, Screening Tool for Older Person's Prescriptions, and PRISCUS), and to determine the PIM prevalence rate in the elderly who utilized long-term care services. Methods We generated a list of drug ingredients included in all the three criteria, and also the current Korean national formulary list. Twenty-six drug ingredients belonging to seven drug classes were finally selected. A two-round Delphi survey consisting of 20 experts was conducted to make a consensus on the PIM criteria applicable to Korean elderly. Individual questions regarding PIM criteria were answered using a 5-point Likert scale. The PIM prevalence rate in elderly was analyzed using the National Health Insurance claims data and the Long-term Care Benefit claims data over a 6-month period (from July 2011 to December 2011). Results All 26 drug ingredients were determined to be PIMs for Korean elderly. The prevalence rate of PIM in elderly under long-term care was 41.4% (98,158/237,285 individuals). Benzodiazepines were the most prevalent PIM drug class (28.9%), followed by first generation antihistamines (26.9%). The use of nonsteroidal anti-inflammatory drugs and tricyclic antidepressants were 9.3% and 6.4% of total individuals, respectively. Conclusion The comprehensive PIM list may be helpful for clinical practitioners to optimize drug choices for their elderly patients. A relatively high PIM prevalence in the elderly suggests that efficient strategies should be designed to reduce PIM in elderly populations in long-term care settings.