Paula A Rochon, Denis O'Mahony, Antonio Cherubini, Graziano Onder, Mirko Petrovic, Kieran Dalton, Lisa M McCarthy, Shelley A Sternberg, Donna R Zwas, Nathan M Stall, Christina E Reppas-Rindlisbacher, Nathalie van der Velde, Sarah N Hilmer, Wei Wu, Joyce Li, Amy Ly, Jerry H Gurwitz
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引用次数: 0
Abstract
Purpose: Prescribing cascades contribute to potentially inappropriate prescribing, especially among older adults. With the prescribing cascade framework maturation, it is important to distinguish potentially inappropriate from potentially appropriate prescribing cascades. The objective was to create a comprehensive consensus list of Potentially Inappropriate Prescribing Cascades (PIPCs).
Methods: A prescribing cascade inventory was compiled using published lists. An international panel of 12 experts in geriatric medicine and pharmacology was selected. Panelists participated in a Delphi consensus process completing two questionnaire rounds and one discussion round.
Results: A total of 107 proposed prescribing cascades were identified. After Questionnaire Round 1, 56 prescribing cascades achieved a rating of agree or strongly agree by ≥ 75% of the panelists and were included in the PIPC list. For 32 of the 107 proposed cascades, 50-74% of panelists provided a rating of agree or strongly agree, and were moved to Round 2. In Questionnaire Round 2, 9 of 32 proposed cascades achieved a rating of agree or strongly agree by ≥ 75% of panelists and were included in the final PIPC list. For 14 prescribing cascades, 50-74% of panelists provided a rating of agree or strongly agree, and were included in the Discussion Round. After discussion, no additional prescribing cascades were included.
Conclusion: An explicit list of 65 PIPCs was created using a rigorous Delphi consensus process conducted by international experts on pharmacotherapy for older adults. The PIPC list provides a crucial tool for clinicians and researchers to detect potentially inappropriate prescribing patterns and to foster efforts to improve medication safety.
期刊介绍：
European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine.
The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
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