Hôpitaux Universitaires de Genève
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1 PIM-Check : a new electronic screening tool to detect and manage potentially inappropriate medications in general internal medicine Hôpitaux Universitaires de Genève Anne-Laure Blanc Pharmacienne 1ère Assemblée Etre de printemps les premiers de la SSMIG pour vous mai 2016
2 2 No conflict of interest
3 PMI definition Potentially inappropriate medications (PIM) Over-prescription Under-prescription Mis-prescription Drug-drug interactions Consequences Risk factors for drug-related problems (DRPs) Extra costs for healthcare system Geriatric s Specific screening tools (STOPP-START,BEERs criteria..) previously shown to reduce the number of PIMs Internal medecine? Co-morbidities and high number of medications Frequent PIM 3
4 Aims of the study An international prescribing screening tool for adults in internal medecine Available as a webmobile app Validated through a Delphi method 4 Including over-undermisprescription and drug-drug interactions 40 international experts (internists, clinical pharmacologists and pharmacists )
5 1 st step Study planning Analyse of Explicit Criteria Published for older adults May 2013 August Nov February 2014 May August 2014 Nov 2015 Research group constitution Selection of themes to be addressed 5
6 2 nd step 1 st step Analyse of Explicit Criteria Published for older adults Literature review Draft criteria agreement May 2013 August Nov February 2014 May August 2014 Nov 2015 Research group constitution Selection of themes to be addressed Semi-structured interviews 6
7 2 nd step 1 st step 3 rd step Analyse of Explicit Criteria Published for older adults Literature review Draft criteria agreement Delphi 1 st round Delphi 2 nd round May 2013 August Nov February 2014 May August 2014 Nov 2015 Research group constitution 7 Selection of themes to be addressed Semi-structured interviews Delphi preparatio n 1 st round results analysis 2 nd round results analysis
8 2 nd step 4 th step 1 st step 3 rd step Analyse of Explicit Criteria Published for older adults Literature review Draft criteria agreement Delphi 1 st round Delphi 2 nd round Forward translation Backtranslation May 2013 August Nov February 2014 May August 2014 Nov 2015 Research group constitution 8 Selection of themes to be addressed Semi-structured interviews Delphi preparatio n 1 st round results analysis 2 nd round results analysis PIM-Check elaboration
9 Results 17 medical fields 58 sub-classes 160 statements 333 References 116 Recommendations 93 Comments 29 Useful links Other 34 Interactions 16 Overprescription 36 Underprescription 74 9
10 17 medical fields 58 sub-classes 160 statements Medical fields Cardiology Angiology/Haemostasis Endocrinology Pneumology Nephrology Gastroenterology Rheumatology Neurology Psychiatry Pain/Analgesia Infectiology Ophthalmology Dependencies Obesity Pharmacology/Toxicology Transplants Vaccination 10
11 11 Medical fields Sub-classes Cardiology 7 Angiology/Haemostasis 2 Endocrinology 3 Pneumology 3 Nephrology 2 Gastroenterology 5 Rheumatology 3 Neurology 2 Psychiatry 4 Pain/Analgesia 3 Infectiology 10 Ophthalmology 1 Dependencies 5 Obesity 1 Pharmacology/Toxicology 2 Transplants 1 Vaccination 1 Hypertension Post-MI Heart failure Atrial fibrillation Diabetes Renal failure Gastric ulcer prevention Psychiatric diseases Pain management Alcoholism
12 Medical fields Sub-classes Statements Cardiology 7 26 Angiology/Haemostasis 2 9 Endocrinology 3 16 Pneumology 3 9 Nephrology 2 7 Gastroenterology 5 11 Rheumatology 3 11 Neurology 2 5 Psychiatry 4 6 Pain/Analgesia 3 8 Infectiology Ophthalmology 1 2 Dependencies 5 9 Obesity 1 4 Pharmacology/Toxicology 2 8 Transplants 1 2 Vaccination Platelet inhibitors, ACEI/sartans, betablockers, antihypertensives statins anticoagulants, heparin PPI Antidepressants, Neuroleptics Antalgesics and opiates Aminoglycosids
13 13
14 Website Webmobile app 14
15 15
16 Perspectives Webmobile app and internet website English version (end summer 2016) Prospective validation study (ongoing) Update based on new published guidelines Further studies planned (hospital and ambulatory care) 16
17 Thank you for you attention! PIM-Check team : Aude Desnoyer, Anne-Laure Blanc, Bertrand Guignard, Pascal Bonnabry Thank you to all participants : Specialists, Delphi s experts, members of the research group, etc Anne-Laure.Blanc@hcuge.ch 17
Nothing to disclose 20/04/2015. Aude DESNOYER PharmD PhD student. Aude DESNOYER PharmD PhD student
Aude DESNOYER PharmD PhD student Seminar M1 Wednesday, 25 March 2015-2:00pm to 3:30pm Thursday, 26 March 2015-9:00am to 10:30am Nothing to disclose Aude DESNOYER PharmD PhD student Seminar M1 Wednesday,
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