{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T03:25:25Z","timestamp":1740108325613,"version":"3.37.3"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001862","name":"The Swedish Research Council","doi-asserted-by":"crossref","award":["[2013-02639]"],"award-info":[{"award-number":["[2013-02639]"]}],"id":[{"id":"10.13039\/501100001862","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Swedish state under the ALF agreement between the Swedish government and the county councils","award":["[ALFGBG-716941]"],"award-info":[{"award-number":["[ALFGBG-716941]"]}]},{"DOI":"10.13039\/501100005760","name":"University of Gothenburg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Pharmacol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To analyse the reliability and validity of the Swedish indicator \u2018Drugs that should be avoided in older people\u2019.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>From a previous study that included consecutive primary care patients\u2009\u2265\u200965 years of age, all patients\u2009\u2265\u200975 years of age were analysed. Two physicians independently screened their medication lists and medical records, applying the Swedish indicator which includes potentially inappropriate medications (PIMs): long-acting benzodiazepines, drugs with anticholinergic action, tramadol, propiomazine, codeine, and glibenclamide. The clinical relevance of identified PIMs was independently assessed. Thereafter, the physicians determined in consensus whether some medical action related to the drug treatment was medically justified and prioritised before the next regular visit. If so, the drug treatment was considered inadequate, and if not, adequate.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 1,146 drugs were assessed in 149 patients (75\u201299 years, 62% female, 0\u201220 drugs per patient). In 29 (19%) patients, at least one physician identified\u2009\u2265\u20091 PIM according to the indicator at issue; 24 (16%) patients were concordantly identified with\u2009\u2265\u20091 such PIM (kappa: 0.89). Of 26 PIMs concordantly identified, the physicians concordantly assessed four as clinically relevant and 12 as not clinically relevant (kappa: 0.17). After the consensus discussion, six (4%) patients had\u2009\u2265\u20091 PIM according to the studied indicator that merited action. Using the area under the receiver operating characteristic (ROC) curve, the indicator did not outperform chance in identifying inadequate drug treatment: 0.56 (95% confidence interval: 0.46 to 0.66).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The Swedish indicator has strong reliability regarding PIM detection but does not validly reflect the adequacy of drug treatment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00228-024-03700-x","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T09:01:58Z","timestamp":1715677318000},"page":"1285-1293","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability and validity of the Swedish indicator \u2018Drugs that should be avoided in older people\u2019\u2014an appraisal of a set of potentially inappropriate medications"],"prefix":"10.1007","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6367-9389","authenticated-orcid":false,"given":"Naldy","family":"Parodi L\u00f3pez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Staffan A.","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"L\u00f6nnbro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna M.","family":"Wallerstedt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"3700_CR1","unstructured":"The National Board of Health and Welfare (2024) Open-access database for dispensed prescription drugs. https:\/\/sdb.socialstyrelsen.se\/if_lak\/val.aspx. 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