• Priscila Horta Novaes, Danielle Teles da Cruz, LucchettiAlessandra Lamas GraneroALGSchool of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais state, Brazil., Isabel Cristina Gonçalves Leite, and Giancarlo Lucchetti.
• School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais state, Brazil.
• Geriatr Gerontol Int. 2017 Oct 1; 17 (10): 1628-1635.

AimTo compare four potentially inappropriate medication (PIM) criteria from different regions of the world in terms of their characteristics, concordance, sensitivity, specificity and predictive values in a community-dwelling sample.MethodsA cross-sectional, observational, epidemiological study was carried out by a door-to-door survey in a Brazilian city. The following PIM criteria were applied: Beers-2015, Screening Tool of Older People's Potentially Inappropriate Prescriptions (STOPP)-2015, The European Union (EU)(7)-PIM list and Taiwan criteria. The associations of criteria with the presence or absence of falls, hospitalizations and cognitive impairment were determined, and their sensitivity, specificity, positive predictive value, negative predictive value and concordance among the criteria were assessed.ResultsA total of 368 (92%) older adults were in continuous use of at least one drug. A high prevalence of PIM by Beers (50.0 %), STOPP (46.2%), EU(7)-PIM (59.5%) and Taiwan 31.3%) criteria was found. There was a high concordance among the PIM criteria (66.3-81.8%), and a moderate-to-high intraclass correlation between criteria (0.607-0.851). In general, the Taiwan criterion had lower levels of sensitivity (25.7-34.0%) and higher levels of specificity (67.8-70.3%), The EU(7)-PIM criteria had higher levels of sensitivity (60-75.3%) and lower levels of specificity (41.1-46.9%), whereas the Beers and STOPP had a more balanced sensitivity/specificity ratio (sensitivity: STOPP 50.7-55.3% and Beers 53.0-56.9 %; specificity: STOPP 56-56.6% and Beers 51.6-53.8%).ConclusionsThe present study found moderate-to-high levels of concordance among the four PIM criteria assessed, pointing to a consensus in this field. However, each criterion showed particular characteristics: the EU(7)-PIM criterion had higher sensitivity, the Taiwan criterion higher specificity, and the Beers and STOPP a more balanced profile. These results highlight that each criterion has its own characteristics, and should be used according to health providers' objectives. Geriatr Gerontol Int 2017; 17: 1628-1635.© 2017 Japan Geriatrics Society.

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