Nina-Kristin Mann, Witten/Herdecke University

Updating the PRISCUS list of potentially inappropriate medications for the elderly
– Asking the right questions to consult the oracle(s) of Delphi
Nina-Kristin Mann1, Tim Mathes2, Andreas Sönnichsen3, Anette Zawinell4, Dawid Pieper2, Petra A. Thürmann1,5
1Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany, nina-kristin.mann@uni-wh.de 2Institute for Research in Operative Medicine,
School of Medicine, Faculty of Health, Witten/Herdecke University, Cologne, Germany 3Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna,
Vienna, Austria 4Research Institute of the Local Health Care Funds (WIdO), Berlin, Germany 5Philipp Klee-Institute for Clinical Pharmacology, Helios University Hospital Wuppertal, Wuppertal, Germany

Background Methods
Step 1 Step 2
• Older patients are often affected by multimorbidity and polypharmacy Identification of possible PIMs via international Delphi survey3, 2 rounds
PIM lists and a literature search
• Older patients are vulnerable to adverse drug events ADE Expert rating of
Review of the prevalence of identified possible inappropriateness of
• Lists of potentially inappropriate medications PIM indicate which drugs to PIMs in German older patients using claims data selected drugs for older
avoid in older patients patients
A lack of evidence is often criticised in PIM lists
• The PRISCUS list1 was the first PIM list developed for the German  syst. reviews2, adapted GRADE
Based on provided data
drug market Preparation of a preliminary drug list and clinical experience
• The PRISCUS list was published in 2010 and is no longer - x

PRISCUS 2.0 Step 3

up-to-date
Installing PRISCUS 2.0 Collection of comments4 on the results of the survey (website)
-Upgrade to new release-
Updating the PRISCUS list based on newly Review and if appropriate incorporation of collected comments
Aim available evidence
Please wait while the Setup
Wizard installs PRISCUS 2.0 Publication of the updated PRISCUS list  PRISCUS 2.0

updates?
This may take several months.
Future
Status:
Survey results Collecting public commentary Delphi survey Drug

250 Preliminary drug list A B C

< Back Next >

Not Not
1st round 23 Not PIM 69 Unclear 158 PIM PIM PIM

Modifications based
on expert commentary Unclear Unclear
PRISCUS
2.0 list
Experts Experts
87 Drug list 2nd round
PRISCUS
PIM PIM
2.0 list
2nd round 13 Not PIM 45 Unclear 29 PIM
2nd round 1st round

1 Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int. 2010 Aug;107(31-32):543-51. 2 Martinez YV, Renom-Guiteras A, Reeves D, et al. A set of systematic reviews to help reduce inappropriate prescribing
to older people: study protocol. BMC Geriatr. 2017 Oct 16;17(Suppl 1):231. 3 McMillan SS, King M, Tully MP. How to use the nominal group and Delphi techniques. Int J Clin Pharm. 2016 Jun;38(3):655-62. 4 By the American Geriatrics Society 2015 Beers Criteria Update
Expert Panel. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015 Nov;63(11):2227-46.
N. K. Mann 01KX1812