February 5, 2024 – Melbourne, Australia – In a pioneering effort, Australian researchers have introduced the country’s first comprehensive list of 16 potentially hazardous medications used in healthcare, along with their safer alternatives. These ‘Potentially Inappropriate Medicines’ (PIMs) pose risks that may outweigh their benefits, including severe adverse effects, drug interactions, an elevated risk of falls, and, in extreme cases, death.
Globally, lists of PIMs serve as crucial tools for healthcare professionals to enhance medication management and safety. Lead researcher, Dr. Kate Wang from RMIT’s School of Health and Biomedical Sciences, emphasized that PIM lists assist clinicians in identifying medications with a higher risk of negative clinical outcomes, such as hospitalization and mortality.
“These medications should only be used in circumstances where there is a clear need and no effective and lower-risk alternative available,” stated Dr. Wang, underlining the uniqueness of the Australian healthcare setting and the necessity for an up-to-date, national resource.
The study involved a multidisciplinary expert panel comprising 33 clinicians and researchers with expertise in geriatrics, general medicine, pharmacy, clinical pharmacology, general practice, and epidemiology. Evaluating 130 medications or medication classes, including internationally recognized PIMs such as benzodiazepines, NSAIDs, and tricyclic antidepressants, the researchers highlighted the outdated nature of Australia’s existing PIMs list, developed 15 years ago.
Dr. Wang emphasized the need for an Australian-specific list, given the disparities in medication availability, prescription practices, clinical guidelines, and the healthcare system. The newly introduced list not only identifies medications where risks outweigh benefits for older individuals but also suggests potentially safer alternatives. Common medications like ibuprofen, lorazepam, and codeine are mentioned, with recommendations for alternatives such as paracetamol.
“This list serves as a valuable tool for Australian healthcare practitioners working with individuals aged 65 and older, offering guidance to researchers, policymakers, consumers, and family members concerned about the risks and potential alternatives to these medications,” explained Dr. Wang. However, she stressed that all medications on the list provide clinical benefits when used appropriately, taking into account individual factors such as allergies, drug interactions, medical conditions, beliefs, experiences, preferences, and goals.
Dr. Wang concluded by highlighting the irreplaceable role of regular, individualized medication reviews, particularly for older individuals prescribed medications listed as PIMs. The researchers are now delving into assessing the prevalence of PIM use in Australia.
