TY  - JOUR
AU  - Fialova, Daniela
AU  - Laffon, Blanca
AU  - Marinković, Valentina
AU  - Tasić, Ljiljana
AU  - Doro, Peter
AU  - Soos, Gyongyver
AU  - Mota, Jorge
AU  - Dogan, Soner
AU  - Brkić, Jovana
AU  - Teixeira, Joao Paulo
AU  - Valdiglesias, Vanessa
AU  - Costa, Solange
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3360
AB  - IntroductionThe importance of rational drug therapy is increasing with the aging of the population. Since one of the main reasons for inappropriate drug prescribing is also the age-blind approach, which results in ageist practices, this narrative literature review focuses on the description of the main barriers related to insufficient individualization of drug regimens associated with such age-blind approaches.MethodologyA narrative literature review using the PubMed, WoS, Embase, and Scopus databases was conducted by the EU COST Action IS1402. Experts in different scientific fields from six countries (the Czech Republic, Spain, Portugal, Hungary, Serbia, and Turkey) worked in four specific areas: (1) underrepresentation of older adults in clinical trials and clinical and ethical consequences; (2) insufficient consideration of age-related changes and geriatric frailty in the evaluation of the therapeutic value of drugs; (3) frequent prescribing of potentially inappropriate medications (PIMs); and (4) frequent underuse of highly beneficial nonpharmacological strategies (e.g., exercise).ResultsOlder patients are underrepresented in clinical trials. Therefore, rigorous observational geriatric research is needed in order to obtain evidence on the real efficacy and safety of frequently used drugs, and e.g. developed geriatric scales and frailty indexes for claims databases should help to stimulate such research. The use of PIMs, unfortunately, is still highly prevalent in Europe: 22.6% in community-dwelling older patients and 49.0% in institutionalized older adults. Specific tests to detect the majority of age-related pharmacological changes are usually not available in everyday clinical practice, which limits the estimation of drug risks and possibilities to individualize drug therapy in geriatric patients before drug prescription. Moreover, the role of somenonpharmacological strategies is highly underestimated in older adultsin contrast to frequent use of polypharmacy. Among nonpharmacological strategies, particularly physical exercise was highly effective in reducing functional decline, frailty, and the risk of falls in the majority of clinicalstudies.ConclusionSeveral regulatory and clinical barriers contribute to insufficient knowledge on the therapeutic value of drugs in older patients, age-blind approach, and inappropriate prescribing. New clinical and observational research is needed, including data on comprehensive geriatric assessment and frailty, to document the real efficacy and safety of frequently used medications.
PB  - Springer Heidelberg, Heidelberg
T2  - European Journal of Clinical Pharmacology
T1  - Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of PIMs and polypharmacy, and underuse of highly beneficial nonpharmacological strat
VL  - 75
IS  - 4
SP  - 451
EP  - 466
DO  - 10.1007/s00228-018-2603-5
ER  - 

@article{
author = "Fialova, Daniela and Laffon, Blanca and Marinković, Valentina and Tasić, Ljiljana and Doro, Peter and Soos, Gyongyver and Mota, Jorge and Dogan, Soner and Brkić, Jovana and Teixeira, Joao Paulo and Valdiglesias, Vanessa and Costa, Solange",
year = "2019",
abstract = "IntroductionThe importance of rational drug therapy is increasing with the aging of the population. Since one of the main reasons for inappropriate drug prescribing is also the age-blind approach, which results in ageist practices, this narrative literature review focuses on the description of the main barriers related to insufficient individualization of drug regimens associated with such age-blind approaches.MethodologyA narrative literature review using the PubMed, WoS, Embase, and Scopus databases was conducted by the EU COST Action IS1402. Experts in different scientific fields from six countries (the Czech Republic, Spain, Portugal, Hungary, Serbia, and Turkey) worked in four specific areas: (1) underrepresentation of older adults in clinical trials and clinical and ethical consequences; (2) insufficient consideration of age-related changes and geriatric frailty in the evaluation of the therapeutic value of drugs; (3) frequent prescribing of potentially inappropriate medications (PIMs); and (4) frequent underuse of highly beneficial nonpharmacological strategies (e.g., exercise).ResultsOlder patients are underrepresented in clinical trials. Therefore, rigorous observational geriatric research is needed in order to obtain evidence on the real efficacy and safety of frequently used drugs, and e.g. developed geriatric scales and frailty indexes for claims databases should help to stimulate such research. The use of PIMs, unfortunately, is still highly prevalent in Europe: 22.6% in community-dwelling older patients and 49.0% in institutionalized older adults. Specific tests to detect the majority of age-related pharmacological changes are usually not available in everyday clinical practice, which limits the estimation of drug risks and possibilities to individualize drug therapy in geriatric patients before drug prescription. Moreover, the role of somenonpharmacological strategies is highly underestimated in older adultsin contrast to frequent use of polypharmacy. Among nonpharmacological strategies, particularly physical exercise was highly effective in reducing functional decline, frailty, and the risk of falls in the majority of clinicalstudies.ConclusionSeveral regulatory and clinical barriers contribute to insufficient knowledge on the therapeutic value of drugs in older patients, age-blind approach, and inappropriate prescribing. New clinical and observational research is needed, including data on comprehensive geriatric assessment and frailty, to document the real efficacy and safety of frequently used medications.",
publisher = "Springer Heidelberg, Heidelberg",
journal = "European Journal of Clinical Pharmacology",
title = "Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of PIMs and polypharmacy, and underuse of highly beneficial nonpharmacological strat",
volume = "75",
number = "4",
pages = "451-466",
doi = "10.1007/s00228-018-2603-5"
}

Fialova, D., Laffon, B., Marinković, V., Tasić, L., Doro, P., Soos, G., Mota, J., Dogan, S., Brkić, J., Teixeira, J. P., Valdiglesias, V.,& Costa, S.. (2019). Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of PIMs and polypharmacy, and underuse of highly beneficial nonpharmacological strat. in European Journal of Clinical Pharmacology
Springer Heidelberg, Heidelberg., 75(4), 451-466.
https://doi.org/10.1007/s00228-018-2603-5

Fialova D, Laffon B, Marinković V, Tasić L, Doro P, Soos G, Mota J, Dogan S, Brkić J, Teixeira JP, Valdiglesias V, Costa S. Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of PIMs and polypharmacy, and underuse of highly beneficial nonpharmacological strat. in European Journal of Clinical Pharmacology. 2019;75(4):451-466.
doi:10.1007/s00228-018-2603-5 .

Fialova, Daniela, Laffon, Blanca, Marinković, Valentina, Tasić, Ljiljana, Doro, Peter, Soos, Gyongyver, Mota, Jorge, Dogan, Soner, Brkić, Jovana, Teixeira, Joao Paulo, Valdiglesias, Vanessa, Costa, Solange, "Medication use in older patients and age-blind approach: narrative literature review (insufficient evidence on the efficacy and safety of drugs in older age, frequent use of PIMs and polypharmacy, and underuse of highly beneficial nonpharmacological strat" in European Journal of Clinical Pharmacology, 75, no. 4 (2019):451-466,
https://doi.org/10.1007/s00228-018-2603-5 . .

TY  - JOUR
AU  - Fialova, Daniela
AU  - Brkić, Jovana
AU  - Laffon, Blanca
AU  - Reissigova, Jindra
AU  - Gresakova, Silvia
AU  - Dogan, Soner
AU  - Doro, Peter
AU  - Tasić, Ljiljana
AU  - Marinković, Valentina
AU  - Valdiglesias, Vanessa
AU  - Costa, Solange
AU  - Kostriba, Jan
PY  - 2019
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/3264
AB  - Background: The European Union (EU)(7)-PIM (potentially inappropriate medication) list presents the most comprehensive and up-to-date tool for evaluation of PIM prescribing in Europe; however, several country-specific studies have documented lower specificity of this list on pharmaceutical markets of some countries. The aim of our study was to describe approval rates and marketing of PIMs stated by EU(7)-PIM criteria in six EU countries [in comparison with the American Geriatric Society (AGS) Beers 2015 criteria]. Methods: Research teams of six EU countries (Czech Republic, Spain, Portugal, Serbia, Hungary and Turkey) participated in this study conducted by WG1b EU COST Action IS1402 group in the period October 2015-November 2018. Data on approval rates of PIMs and their availability on pharmaceutical markets have been obtained from databases of national drug-regulatory institutes and up-to-date drug compendia. The EU(7)-PIM list and AGS Beers 2015 Criteria (Section 1) were applied. Results: PIMs from EU(7)-PIM list were approved for clinical use more often than those from the AGS Beers 2015 criteria (Section 1). Approval rates for EU(7)-PIMs ranged from 42.8% in Serbia to 71.4% in Spain (for AGS criteria only from 36.4% to 65.1%, respectively). Higher percentages of approved PIMs were documented in Spain (71.4%), Portugal (67.1%) and Turkey (67.5%), lower in Hungary (55.5%), Czech Republic (50.2%) and Serbia (42.8%). The majority of approved PIMs were also currently marketed in all countries except in Turkey (19.8-21.7% not marketed PIMs) and less than 20% of PIMs were available as over-the-counter medications (except in Turkey, 46.4-48.1%). Conclusions: The EU(7)-PIM list was created for utilization in European studies; however, applicability of this list is still limited in some countries, particularly in Eastern and Central Europe. The EU project EUROAGEISM H2020 (2017-2021) that focuses on PIM prescribing and regulatory measures in Central and Eastern European countries must consider these limits.
PB  - Sage Publications Ltd, London
T2  - Therapeutic Advances in Drug Safet
T1  - Applicability of EU(7)-PIM criteria in cross-national studies in European countries
VL  - 10
DO  - 10.1177/2042098619854014
ER  - 

@article{
author = "Fialova, Daniela and Brkić, Jovana and Laffon, Blanca and Reissigova, Jindra and Gresakova, Silvia and Dogan, Soner and Doro, Peter and Tasić, Ljiljana and Marinković, Valentina and Valdiglesias, Vanessa and Costa, Solange and Kostriba, Jan",
year = "2019",
abstract = "Background: The European Union (EU)(7)-PIM (potentially inappropriate medication) list presents the most comprehensive and up-to-date tool for evaluation of PIM prescribing in Europe; however, several country-specific studies have documented lower specificity of this list on pharmaceutical markets of some countries. The aim of our study was to describe approval rates and marketing of PIMs stated by EU(7)-PIM criteria in six EU countries [in comparison with the American Geriatric Society (AGS) Beers 2015 criteria]. Methods: Research teams of six EU countries (Czech Republic, Spain, Portugal, Serbia, Hungary and Turkey) participated in this study conducted by WG1b EU COST Action IS1402 group in the period October 2015-November 2018. Data on approval rates of PIMs and their availability on pharmaceutical markets have been obtained from databases of national drug-regulatory institutes and up-to-date drug compendia. The EU(7)-PIM list and AGS Beers 2015 Criteria (Section 1) were applied. Results: PIMs from EU(7)-PIM list were approved for clinical use more often than those from the AGS Beers 2015 criteria (Section 1). Approval rates for EU(7)-PIMs ranged from 42.8% in Serbia to 71.4% in Spain (for AGS criteria only from 36.4% to 65.1%, respectively). Higher percentages of approved PIMs were documented in Spain (71.4%), Portugal (67.1%) and Turkey (67.5%), lower in Hungary (55.5%), Czech Republic (50.2%) and Serbia (42.8%). The majority of approved PIMs were also currently marketed in all countries except in Turkey (19.8-21.7% not marketed PIMs) and less than 20% of PIMs were available as over-the-counter medications (except in Turkey, 46.4-48.1%). Conclusions: The EU(7)-PIM list was created for utilization in European studies; however, applicability of this list is still limited in some countries, particularly in Eastern and Central Europe. The EU project EUROAGEISM H2020 (2017-2021) that focuses on PIM prescribing and regulatory measures in Central and Eastern European countries must consider these limits.",
publisher = "Sage Publications Ltd, London",
journal = "Therapeutic Advances in Drug Safet",
title = "Applicability of EU(7)-PIM criteria in cross-national studies in European countries",
volume = "10",
doi = "10.1177/2042098619854014"
}

Fialova, D., Brkić, J., Laffon, B., Reissigova, J., Gresakova, S., Dogan, S., Doro, P., Tasić, L., Marinković, V., Valdiglesias, V., Costa, S.,& Kostriba, J.. (2019). Applicability of EU(7)-PIM criteria in cross-national studies in European countries. in Therapeutic Advances in Drug Safet
Sage Publications Ltd, London., 10.
https://doi.org/10.1177/2042098619854014

Fialova D, Brkić J, Laffon B, Reissigova J, Gresakova S, Dogan S, Doro P, Tasić L, Marinković V, Valdiglesias V, Costa S, Kostriba J. Applicability of EU(7)-PIM criteria in cross-national studies in European countries. in Therapeutic Advances in Drug Safet. 2019;10.
doi:10.1177/2042098619854014 .

Fialova, Daniela, Brkić, Jovana, Laffon, Blanca, Reissigova, Jindra, Gresakova, Silvia, Dogan, Soner, Doro, Peter, Tasić, Ljiljana, Marinković, Valentina, Valdiglesias, Vanessa, Costa, Solange, Kostriba, Jan, "Applicability of EU(7)-PIM criteria in cross-national studies in European countries" in Therapeutic Advances in Drug Safet, 10 (2019),
https://doi.org/10.1177/2042098619854014 . .

TY  - CONF
AU  - Fialova, Daniela
AU  - Vysinova, Tereza
AU  - Gresakova, Silvia
AU  - Laffon-Deusdad, Blanca
AU  - Doro, Peter
AU  - Dogan, Soner
AU  - Costa, Solange
AU  - Valdiglesias, Vanessa
AU  - Brkić, Jovana
AU  - Marinković, Valentina
PY  - 2017
UR  - https://farfar.pharmacy.bg.ac.rs/handle/123456789/2950
PB  - Springer, Dordrecht
C3  - International Journal of Clinical Pharmacy
T1  - Potentially inappropriate medications in the elderly and their different approval rates in countries participating in the EU COST Action 1402 initiative
VL  - 39
IS  - 1
SP  - 310
EP  - 311
DO  - 10.1007/s11096-016-0404-4
ER  - 

@conference{
author = "Fialova, Daniela and Vysinova, Tereza and Gresakova, Silvia and Laffon-Deusdad, Blanca and Doro, Peter and Dogan, Soner and Costa, Solange and Valdiglesias, Vanessa and Brkić, Jovana and Marinković, Valentina",
year = "2017",
publisher = "Springer, Dordrecht",
journal = "International Journal of Clinical Pharmacy",
title = "Potentially inappropriate medications in the elderly and their different approval rates in countries participating in the EU COST Action 1402 initiative",
volume = "39",
number = "1",
pages = "310-311",
doi = "10.1007/s11096-016-0404-4"
}

Fialova, D., Vysinova, T., Gresakova, S., Laffon-Deusdad, B., Doro, P., Dogan, S., Costa, S., Valdiglesias, V., Brkić, J.,& Marinković, V.. (2017). Potentially inappropriate medications in the elderly and their different approval rates in countries participating in the EU COST Action 1402 initiative. in International Journal of Clinical Pharmacy
Springer, Dordrecht., 39(1), 310-311.
https://doi.org/10.1007/s11096-016-0404-4

Fialova D, Vysinova T, Gresakova S, Laffon-Deusdad B, Doro P, Dogan S, Costa S, Valdiglesias V, Brkić J, Marinković V. Potentially inappropriate medications in the elderly and their different approval rates in countries participating in the EU COST Action 1402 initiative. in International Journal of Clinical Pharmacy. 2017;39(1):310-311.
doi:10.1007/s11096-016-0404-4 .

Fialova, Daniela, Vysinova, Tereza, Gresakova, Silvia, Laffon-Deusdad, Blanca, Doro, Peter, Dogan, Soner, Costa, Solange, Valdiglesias, Vanessa, Brkić, Jovana, Marinković, Valentina, "Potentially inappropriate medications in the elderly and their different approval rates in countries participating in the EU COST Action 1402 initiative" in International Journal of Clinical Pharmacy, 39, no. 1 (2017):310-311,
https://doi.org/10.1007/s11096-016-0404-4 . .