Potentially inappropriate medication use is common among older people in Finland according to the national Meds75+ database, but the prevalence is dependent on the applied criteria – reports a study published in BMCGeriatr.
] which found that the top three PIMs varied significantly between the six criteria. However, they analyzed different criteria and had a small sample size which affects comparability. We detected codeine , etoricoxib PIM list, PRISCUS list and Red-Yellow-Green list), ibuprofen , nitrofurantoin and/or tramadol PIM list and Swedish criteria) as the most-used PIMs in three different criteria.
On the other hand, certain limitations should be noted. First, seven medicines were misinterpreted from the EU-PIM list and were not included in the data collection . Consequently, the actual prevalence of PIM use according the EU-PIM list was underestimated.
Third, information on purchases rather than actual intake of medicines is a limitation. However, analysis of actual intake at nationwide scale is hardly possible. Furthermore, we could not take OTC medicines into account as the Prescription Centre does not register their use. As some PIMs are available also without prescription in Finland , their actual use may be greater than we have observed.
Forth, we did not take into account those cases where PIM status of a medicine is limited to certain doses, indications, types of pharmaceutical form or duration of treatment. Although the Prescription Centre includes detailed information about deliveries , dosage instructions are not recorded in such systematic way that would allow consideration of dosages or indications and collecting such information manually from the extensive data would have been unnecessarily challenging.
Fifth, although the included criteria are intended for use in older persons, the age limit for this age group varies. Different age limits may affect which medications are considered as PIMs and thereby partly explain the variation in the observed prevalences. As the medicines that are considered as PIMs for older persons aged 65 or over should - quite obviously – be avoided in persons aged 75 years or over as well, all included criteria can be applied to our study population.
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