TY - JOUR
T1 - Clinical medication review tool for polypharmacy
T2 - Mapping approach for pharmacotherapeutic classifications
AU - Mizokami, Fumihiro
AU - Mizuno, Tomohiro
AU - Mori, Tomoyo
AU - Nagamatsu, Tadashi
AU - Endo, Hideharu
AU - Hirashita, Tomoyuki
AU - Ichino, Takanobu
AU - Akishita, Masahiro
AU - Furuta, Katsunori
N1 - Funding Information:
This research was supported by the Comprehensive Research on Aging and Health from the Japan Agency for Medical Research and Development (AMED). FM conceived and designed the study and wrote the paper. TM, TM and TN analyzed the data. HE, TH and TI participated in data collection. MA and KF participated in the interpretation and discussion of the data. All authors have read and approved the final manuscript.
Publisher Copyright:
© 2017 Japan Geriatrics Society
PY - 2017/11
Y1 - 2017/11
N2 - Aim: Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients. Methods: The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012. Results: We propose a new method called the Mapping Approach for Pharmacotherapeutic Classifications: (i) identify the chronic disease-anatomical therapeutic class code assigned to the prescription drugs; (ii) identify the chronic disease-anatomical therapeutic class code corresponding to the patient's chronic disease; (iii) compare the prescription drug and patient's chronic disease chronic disease-anatomical therapeutic class codes; and (iv) identify the appropriateness of medication use based on the comparison (appropriate use is defined as matching codes). The mean number of potentially inappropriate medications detected was significantly different between the mapping approach and Beers criteria 2012 (3.1 ± 2.6 vs 0.6 ± 0.8 drugs, respectively; P < 0.001). Conclusions: The Mapping Approach for Pharmacotherapeutic Classifications is highly dependent on the chronic condition. Pharmacists should confirm the chronic condition with the treating physician before reducing a patient's medications. We hope this process will further influence prescribing patterns, and decrease the inappropriate use of medications and associated adverse drug reactions in older adults. Geriatr Gerontol Int 2017; 17: 2025–2033.
AB - Aim: Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients. Methods: The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012. Results: We propose a new method called the Mapping Approach for Pharmacotherapeutic Classifications: (i) identify the chronic disease-anatomical therapeutic class code assigned to the prescription drugs; (ii) identify the chronic disease-anatomical therapeutic class code corresponding to the patient's chronic disease; (iii) compare the prescription drug and patient's chronic disease chronic disease-anatomical therapeutic class codes; and (iv) identify the appropriateness of medication use based on the comparison (appropriate use is defined as matching codes). The mean number of potentially inappropriate medications detected was significantly different between the mapping approach and Beers criteria 2012 (3.1 ± 2.6 vs 0.6 ± 0.8 drugs, respectively; P < 0.001). Conclusions: The Mapping Approach for Pharmacotherapeutic Classifications is highly dependent on the chronic condition. Pharmacists should confirm the chronic condition with the treating physician before reducing a patient's medications. We hope this process will further influence prescribing patterns, and decrease the inappropriate use of medications and associated adverse drug reactions in older adults. Geriatr Gerontol Int 2017; 17: 2025–2033.
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U2 - 10.1111/ggi.13014
DO - 10.1111/ggi.13014
M3 - Article
C2 - 28371121
AN - SCOPUS:85017032557
VL - 17
SP - 2025
EP - 2033
JO - Geriatrics and Gerontology International
JF - Geriatrics and Gerontology International
SN - 1444-1586
IS - 11
ER -