{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:55:36Z","timestamp":1791201336115,"version":"4.2.0"},"reference-count":34,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017513","name":"Sichuan Science and Technology Program","doi-asserted-by":"publisher","award":["2026NSFSC1590"],"award-info":[{"award-number":["2026NSFSC1590"]}],"id":[{"id":"10.13039\/100017513","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Objectives: Potentially inappropriate medication (PIM) use remains highly prevalent among older outpatients, yet individualized risk prediction tools are limited. This study aimed to develop and validate a PIM risk prediction model incorporating a novel disease-weighted index. Methods: A multicenter cross-sectional study was conducted using 131,894 outpatient prescriptions from 59 medical institutions in China. Diagnoses were mapped to ICD-10 codes. A PIM Risk-Related Comorbidity Index (PRCI) was developed using multivariable logistic regression and coefficient-weighted scoring. A prediction model was constructed and internally validated using a 6:4 split-sample approach. Discrimination, calibration, and clinical utility were assessed using ROC curves, calibration plots, and decision curve analysis. Results: The proportion of prescriptions containing at least one PIM was 29.0%. Polypharmacy showed a strong dose\u2013response relationship with PIM risk. The PRCI was independently associated with PIM (OR = 1.07 per unit increase). The final model demonstrated good discrimination (AUC = 0.775 in training and 0.773 in validation), satisfactory calibration, and favorable clinical utility. A cutoff probability of 0.304 stratified prescriptions into high- and low-risk groups. Conclusions: The PRCI-based model provides an individualized and clinically applicable tool for identifying older outpatient prescriptions at high risk of containing PIMs, supporting proactive medication safety management.<\/jats:p>","DOI":"10.3390\/jcm15197675","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:57:46Z","timestamp":1791197866000},"page":"7675","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A PRCI-Based Individualized Risk Prediction Model for Potentially Inappropriate Medication in Older Outpatients"],"prefix":"10.3390","volume":"15","author":[{"given":"Zhaoyan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3501-1147","authenticated-orcid":false,"given":"Congjun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1290-1156","authenticated-orcid":false,"given":"Yongfei","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6795-582X","authenticated-orcid":false,"given":"Cairong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"glag176","DOI":"10.1093\/gerona\/glag176","article-title":"Global prevalence, trends, and dose-response associations of polypharmacy in older adults","volume":"81","author":"Tian","year":"2026","journal-title":"J. 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