Ann Geriatr Med Res.  2018 Sep;22(3):121-129. 10.4235/agmr.2018.22.3.121.

Development of a Consensus List of Potentially Inappropriate Medications for Korean Older Adults

Affiliations
  • 1Department of Family Medicine, Seoul Medical Center, Seoul, Korea.
  • 2School of Medicine and Pharmacology, The University of Western Australia, Crawley, Australia.
  • 3Environmental Health Center, Korea University Anam Hospital, Seoul, Korea.
  • 4Department of Family Medicine, College of Medicine, Hallym University, Chuncheon, Korea.
  • 5Institute of Geriatric Medicine, Incheon Eun-Hye Hospital, Incheon, Korea.
  • 6Department of Psychiatry, National Medical Center, Seoul, Korea.
  • 7Department of Rheumatology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 8Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
  • 9Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea. chunwon62@naver.com

Abstract

BACKGROUND
Korea has recently attained the aged society status and the growth rate of the aging population will be among the most rapid worldwide. The objective of this study was to develop a credible list of potentially inappropriate medications (PIMs) for Korean older adults.
METHODS
A new Korean PIMs list was produced through a comprehensive structured expert survey (modified Delphi method). To generate an expert panel, we invited the nomination of experts in geriatric medication from the Korean Geriatric Society, the Korean Academy of Clinical Geriatrics, the Korean Academy of Family Medicine, the Korean Association for Geriatric Psychiatry, and the Korean Association of Geriatric Hospitals. Based on their recommendation, the expert panel consisted of 14 geriatric specialists, including 10 geriatricians (7 family medicine doctors and 3 internal medicine doctors), 3 geriatric psychiatrists, and 1 clinical pharmacist. After 4 rounds, the new Korean PIMs list was finalized.
RESULTS
Sixty-two drugs were classified as PIMs for older adults irrespective of comorbidities, including antipsychotics, tricyclic antidepressants, benzodiazepines, nonsteroidal anti-inflammatory drugs, and first-generation antihistamines. Forty-eight drugs or drug categories were classified as PIMs for 18 specific conditions that older adults encounter frequently. The expert panel presented the rationale and comments including preferred therapeutic alternatives and exceptional situations for each item.
CONCLUSION
We presented a "user-friendly" PIMs list for Korean older adults. Further prospective studies to validate its usefulness in clinical settings and regular updating of the list are required. It is also important to disseminate this list to doctors who prescribe medication to older people.

Keyword

Potentially inappropriate medication list; Drug-related side effects and adverse reactions; Korea
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