{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:09:50Z","timestamp":1790507390847,"version":"4.1.0"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007543","name":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de Sant\u00e9","doi-asserted-by":"publisher","award":["2014s029"],"award-info":[{"award-number":["2014s029"]}],"id":[{"id":"10.13039\/501100007543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We aimed to describe the burden represented by potentially inappropriate medications (PIMs) in chronic polypharmacy in France. We conducted a nationwide cross-sectional study using data from the French National Insurance databases. The study period was from 1 January 2016 to 31 December 2016. Chronic drug use was defined as uninterrupted daily use lasting \u22656 months. Chronic polypharmacy was defined as the chronic use of \u22655 medications, and chronic hyperpolypharmacy as the chronic use of \u226510 medications. For individuals aged \u226565 (older adults), PIMs were defined according to the Beers and Laroche lists, and for individuals aged 45\u201364 years (middle-aged) PIMs were defined according to the PROMPT (Prescribing Optimally in Middle-aged People\u2019s Treatments) list. Among individuals with chronic polypharmacy, 4009 (46.2%) middle-aged and 18,036 (64.8%) older adults had at least one chronic PIM. Among individuals with chronic hyperpolypharmacy, these figures were, respectively, 570 (75.0%) and 2544 (88.7%). The most frequent chronic PIM were proton pump inhibitors (43.4% of older adults with chronic polypharmacy), short-acting benzodiazepines (older adults: 13.7%; middle-aged: 16.1%), hypnotics (6.1%; 7.4%), and long-acting sulfonylureas (3.9%; 12.3%). The burden of chronic PIM appeared to be very high in our study, concerning almost half of middle-aged adults and two-thirds of older adults with chronic polypharmacy. Deprescribing interventions in polypharmacy should primarily target proton pump inhibitors and hypnotics.<\/jats:p>","DOI":"10.3390\/jcm9113728","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T09:46:18Z","timestamp":1605865578000},"page":"3728","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["The Burden of Potentially Inappropriate Medications in Chronic Polypharmacy"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9091-0571","authenticated-orcid":false,"given":"Jordan","family":"Guillot","sequence":"first","affiliation":[{"name":"INSERM U1219, Bordeaux Population Health, Team Pharmacoepidemiology, University of Bordeaux, F-33000 Bordeaux, France"},{"name":"Service de Pharmacologie M\u00e9dicale, P\u00f4le de Sant\u00e9 Publique, CHU de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Maumus-Robert","sequence":"additional","affiliation":[{"name":"INSERM U1219, Bordeaux Population Health, Team Pharmacoepidemiology, University of Bordeaux, F-33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Marceron","sequence":"additional","affiliation":[{"name":"Service de Pharmacologie M\u00e9dicale, P\u00f4le de Sant\u00e9 Publique, CHU de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernelle","family":"Noize","sequence":"additional","affiliation":[{"name":"INSERM U1219, Bordeaux Population Health, Team Pharmacoepidemiology, University of Bordeaux, F-33000 Bordeaux, France"},{"name":"Service de Pharmacologie M\u00e9dicale, P\u00f4le de Sant\u00e9 Publique, CHU de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7873-5483","authenticated-orcid":false,"given":"Antoine","family":"Pariente","sequence":"additional","affiliation":[{"name":"INSERM U1219, Bordeaux Population Health, Team Pharmacoepidemiology, University of Bordeaux, F-33000 Bordeaux, France"},{"name":"Service de Pharmacologie M\u00e9dicale, P\u00f4le de Sant\u00e9 Publique, CHU de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2568-1928","authenticated-orcid":false,"given":"Julien","family":"Bezin","sequence":"additional","affiliation":[{"name":"INSERM U1219, Bordeaux Population Health, Team Pharmacoepidemiology, University of Bordeaux, F-33000 Bordeaux, France"},{"name":"Service de Pharmacologie M\u00e9dicale, P\u00f4le de Sant\u00e9 Publique, CHU de Bordeaux, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"ref_1","first-page":"9","article-title":"Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies","volume":"22","author":"Nguyen","year":"2019","journal-title":"J. Comorb."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1001\/jama.2015.13766","article-title":"Trends in Prescription Drug Use Among Adults in the United States From 1999\u20132012","volume":"3314","author":"Kantor","year":"2015","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2147\/CLEP.S153458","article-title":"The epidemiology of polypharmacy in older adults: Register-based prospective cohort study","volume":"10","author":"Morin","year":"2018","journal-title":"Clin. Epidemiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.therap.2019.10.001","article-title":"Polypharmacy: A general review of definitions, descriptions and determinants","volume":"75","author":"Guillot","year":"2020","journal-title":"Therapies"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S0140-6736(12)60240-2","article-title":"Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study","volume":"380","author":"Barnett","year":"2012","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Masnoon, N., Shakib, S., Kalisch-Ellett, L., and Caughey, G.E. (2017). What is polypharmacy? A systematic review of definitions. BMC Geriatr., 17.","DOI":"10.1186\/s12877-017-0621-2"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1111\/jgs.13153","article-title":"Health Outcomes Associated with Polypharmacy in Community-Dwelling Older Adults: A Systematic Review","volume":"62","author":"Fried","year":"2014","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"d3514","DOI":"10.1136\/bmj.d3514","article-title":"High risk prescribing in primary care patients particularly vulnerable to adverse drug events: Cross sectional population database analysis in Scottish general practice","volume":"342","author":"Guthrie","year":"2011","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1007\/s00228-015-1860-9","article-title":"The EU(7)-PIM list: A list of potentially inappropriate medications for older people consented by experts from seven European countries","volume":"71","author":"Meyer","year":"2015","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1007\/s00228-015-1950-8","article-title":"Potentially inappropriate prescribing and adverse drug reactions in the elderly: A population-based study","volume":"71","author":"Hedna","year":"2015","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Opondo, D., Eslami, S., Visscher, S., de Rooij, S.E., Verheij, R., Korevaar, J.C., and Abu-Hanna, A. (2012). Inappropriateness of medication prescriptions to elderly patients in the primary care setting: A systematic review. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0043617"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00228-012-1223-8","article-title":"Inappropriate prescribing for the elderly\u2014A modern epidemic?","volume":"68","author":"Nyborg","year":"2012","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1345\/aph.1M657","article-title":"Inappropriate prescribing predicts adverse drug events in older adults","volume":"44","author":"Lund","year":"2010","journal-title":"Ann. Pharmacother."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/1060028013504904","article-title":"Association between potentially inappropriate medications from the Beers criteria and the risk of unplanned hospitalization in elderly patients","volume":"48","author":"Price","year":"2014","journal-title":"Ann. Pharmacother."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Reich, O., Rosemann, T., Rapold, R., Blozik, E., and Senn, O. (2014). Potentially inappropriate medication use in older patients in Swiss managed care plans: Prevalence, determinants and association with hospitalization. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0105425"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jamda.2016.11.025","article-title":"The Association of Potentially Inappropriate Medication at Older Age with Cardiovascular Events and Overall Mortality: A Systematic Review and Meta-Analysis of Cohort Studies","volume":"18","author":"Muhlack","year":"2017","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_17","first-page":"954","article-title":"The national healthcare system claims databases in France, SNIIRAM and EGB: Powerful tools for pharmacoepidemiology","volume":"26","author":"Bezin","year":"2017","journal-title":"Pharm. Drug Saf."},{"key":"ref_18","unstructured":"IMS Health (2005). Enqu\u00eate Permanente Sur La Prescription M\u00e9dicale (EPPM), IMS Health."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1002\/pds.1230","article-title":"Methods for evaluation of medication adherence and persistence using automated databases","volume":"15","author":"Andrade","year":"2006","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1093\/aje\/kwn135","article-title":"Immeasurable time bias in observational studies of drug effects on mortality","volume":"168","author":"Suissa","year":"2008","journal-title":"Am. J. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/j.1365-2125.2010.03628.x","article-title":"Potentially inappropriate prescribing and cost outcomes for older people: A national population study","volume":"69","author":"Cahir","year":"2010","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_22","first-page":"1242","article-title":"Application of the STOPP\/START criteria to a medical record database","volume":"26","author":"Nauta","year":"2017","journal-title":"Pharm. Drug Saf."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1111\/jgs.13320","article-title":"Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria","volume":"63","author":"Davidoff","year":"2015","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s00228-018-2446-0","article-title":"Potentially inappropriate medication in the elderly: A systematic review of validated explicit criteria","volume":"74","author":"Motter","year":"2018","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"2019 American Geriatrics Society Beers Criteria\u00ae Update Expert Panel (2019). American Geriatrics Society 2019 Updated AGS Beers Criteria\u00ae for Potentially Inappropriate Medication Use in Older Adults. J. Am. Geriatr. Soc., 67, 674\u2013694.","DOI":"10.1111\/jgs.15767"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1007\/s00228-007-0324-2","article-title":"Potentially inappropriate medications in the elderly: A French consensus panel list","volume":"63","author":"Laroche","year":"2007","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cooper, J.A., Ryan, C., Smith, S.M., Wallace, E., Bennett, K., Cahir, C., Williams, D., Teeling, M., Fahey, T., and Hughes, C.M. (2014). The development of the PROMPT (PRescribing Optimally in Middle-aged People\u2019s Treatments) criteria. BMC Health Serv. Res., 14.","DOI":"10.1186\/s12913-014-0484-6"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Alhawassi, T.M., Alatawi, W., and Alwhaibi, M. (2019). Prevalence of potentially inappropriate medications use among older adults and risk factors using the 2015 American Geriatrics Society Beers criteria. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1168-1"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/jep.12452","article-title":"Polypharmacy and potentially inappropriate prescriptions identified by Beers and STOPP criteria in co-morbid older patients at hospital discharge","volume":"22","author":"Hudhra","year":"2016","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Thorell, K., Midl\u00f6v, P., Fastbom, J., and Halling, A. (2020). Use of potentially inappropriate medication and polypharmacy in older adults: A repeated cross-sectional study. BMC Geriatr., 20.","DOI":"10.1186\/s12877-020-1476-5"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"915","DOI":"10.2165\/00002512-200623110-00006","article-title":"Potentially Inappropriate Medication Prescribing for Elderly Outpatients in Emilia Romagna, Italy: A Population-Based Cohort Study","volume":"23","author":"Maio","year":"2006","journal-title":"Drugs Aging."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s00228-015-2003-z","article-title":"Potentially inappropriate prescribing in two populations with differing socio-economic profiles: A cross-sectional database study using the PROMPT criteria","volume":"72","author":"Cooper","year":"2016","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Agence Nationale de S\u00e9curit\u00e9 du M\u00e9dicament et des Produits de Sant\u00e9 (ANSM) (2018). Utilisation des inhibiteurs de la pompe \u00e0 protons (IPP), \u00c9tude observationnelle \u00e0 partir des donn\u00e9es du SNDS, France, 2015. Rev. \u00c9pid\u00e9miologie St. Publique, 66, S221.","DOI":"10.1016\/j.respe.2018.04.021"},{"key":"ref_34","unstructured":"(2020, August 06). Proton Pump Inhibitors (PPI) Medicines Review\u2014Consumer Reports [Internet]. Available online: https:\/\/www.consumerreports.org\/cro\/2013\/07\/best-drugs-to-treat-heartburn-and-gerd\/index.htm."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1002\/lio2.187","article-title":"Proton pump inhibitors: Review of reported risks and controversies","volume":"3","author":"Brisebois","year":"2018","journal-title":"Laryngoscope Investig Otolaryngol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"182","DOI":"10.5056\/jnm18001","article-title":"Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use","volume":"24","author":"Kinoshita","year":"2018","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_37","unstructured":"Benard, A., Gage, S.B., Canarelli, T., Cavali\u00e9, P., Chatila, K., Collin, C., Delorme, B., Leplay, M., Monzon, E., and Pariente, A. (2020, October 05). \u00c9tat des Lieux de la Consommation des Benzodiaz\u00e9pines en France. Available online: https:\/\/ansm.sante.fr\/S-informer\/Points-d-information-Points-d-information\/Etat-des-lieux-de-la-consommation-des-benzodiazepines-Point-d-Information."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00406-018-0966-3","article-title":"Use of benzodiazepines and z-drugs not compliant with guidelines and associated factors: A population-based study","volume":"270","author":"Panes","year":"2020","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_39","first-page":"162","article-title":"Trends in incident use of benzodiazepines and Z-drugs in France from 2006 to 2012: A population-based study","volume":"26","author":"Noize","year":"2017","journal-title":"Pharm. Drug Saf."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1007\/s00228-016-2044-y","article-title":"Comorbidities and concurrent medications increasing the risk of adverse drug reactions: Prevalence in French benzodiazepine users","volume":"72","author":"Noize","year":"2016","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"k2693","DOI":"10.1136\/bmj.k2693","article-title":"Sulfonylureas as second line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycaemic events: Population based cohort study","volume":"362","author":"Douros","year":"2018","journal-title":"BMJ"},{"key":"ref_42","first-page":"e1","article-title":"How to Use the AGS 2015 Beers Criteria\u2014A Guide for Patients, Clinicians, Health Systems, and Payors","volume":"63","author":"Beizer","year":"2015","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1001\/archinternmed.2009.206","article-title":"Agreement Between Drugs-to-Avoid Criteria and Expert Assessments of Problematic Prescribing","volume":"169","author":"Steinman","year":"2009","journal-title":"Arch. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"k3532","DOI":"10.1136\/bmj.k3532","article-title":"The reporting of studies conducted using observational routinely collected health data statement for pharmacoepidemiology (RECORD-PE)","volume":"363","author":"Langan","year":"2018","journal-title":"BMJ"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3728\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:34:49Z","timestamp":1760178889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/11\/3728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,20]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["jcm9113728"],"URL":"https:\/\/doi.org\/10.3390\/jcm9113728","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,20]]}}}