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Ann Rehabil Med  <  Volume 22(3); 2018 <  Articles

Ann Geriatr Med Res 2018; 22(3): 121-129  https://doi.org/10.4235/agmr.2018.22.3.121
Development of a Consensus List of Potentially Inappropriate Medications for Korean Older Adults
Moo-Young Kim1, Christopher Etherton-Beer2, Chae-Bong Kim3, Jong Lull Yoon4, Hyuk Ga5, Hyun Chung Kim6, Jung Soo Song7, Kwang-il Kim8, Chang Won Won9
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
Correspondence to: Chang Won Won, MD, PhD
https://orcid.org/0000-0002-6429-4461
Elderly Frailty Research Center, Department of Family Medicine, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea
Tel: +82-2-958-8691
Fax: +82-2-958-8699
E-mail: chunwon62@naver.com
Received: May 30, 2018; Revised: June 15, 2018; Accepted: June 15, 2018; Published online: September 30, 2018.
© The Korea Geriatrics Society. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Potentially inappropriate medication list, Drug-related side effects and adverse reactions, Korea


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