Impact of the publication of the Finnish Meds75+ database on the use of potentially inappropriate medications in older persons

Abstract

AbstractAimsTo evaluate the impact of the updated nationwide Meds75+ database and its linkage to the Finnish health portal on the use of potentially inappropriate medications (PIMs) among older persons. We also aimed to evaluate whether there is regional variation in trend changes of PIM use.MethodsMeds75+ was implemented at the population level in 2015, so randomization is unfeasible. We used a quasi‐experimental interrupted time series analysis to evaluate the changes in levels and trends of PIM use. The data included all Finnish community‐dwelling persons aged ≥75 years (N = 920 163) who had medication purchases in the Prescription Register during 2009‐2020. Data were linked with the Care Registers for Health and Social Care and the cause of death register.ResultsThe prevalence of PIMs decreased from 20.2% in 2009 to 11.7% in 2020. The change of level of the monthly PIM users was negative (β −0.036, 95% confidence interval [CI] −0.202 to 0.131), but not statistically significant (P = .673) after the publication of the database. We found a small decrease (β −0.018, 95% CI −0.083 to 0.047, P = .593) in the slope of PIM users, but it was not statistically significant. The regional results were similar to the main findings.ConclusionsPublication of the updated Meds75+ database did not decrease the level or trend of PIM users. In addition, this study did not show any significant regional variation in PIM use trends. Further research should focus on determining barriers and facilitators to the utilization of PIM criteria in clinical practice.