Variability in the prevalence of inappropriate medication use among older adults: A review highlighting the importance of screening methods and database types.

drug prescription inappropriate prescription medication databases prevalence assessment

Journal

British journal of clinical pharmacology
ISSN: 1365-2125
Titre abrégé: Br J Clin Pharmacol
Pays: England
ID NLM: 7503323

Informations de publication

Date de publication:
16 May 2024
Historique:
revised: 16 01 2024
received: 11 10 2023
accepted: 05 03 2024
medline: 16 5 2024
pubmed: 16 5 2024
entrez: 16 5 2024
Statut: aheadofprint

Résumé

The global older population is growing rapidly, and the rise in polypharmacy has increased potentially inappropriate medication (PIM) encounters. PIMs pose health risks, but detecting them automatically in large medical databases is complex. This review aimed to uncover PIM prevalence in individuals aged 65 years or older using health databases and emphasized the risk of underestimating PIM prevalence due to underutilization of detection tools. This study conducted a broad search on the Medline database to identify articles about the prevalence of PIMs in older adults using various databases. Articles published between January 2010 and June 2023 were included, and specific criteria were applied for study selection. Two literature reviews conducted before our study period were integrated to obtain a perspective from the 1990s to the present day. The selected papers were analysed for variables including database type, screening method, adaptations and PIM prevalence. The study categorized databases and original screening tools for clarity, examined adaptations and assessed concordance among different screening methods. This study encompassed 48 manuscripts, covering 58 sample evaluations. The mean prevalence of PIMs within the general population aged over 65 years was 27.8%. Relevant heterogeneity emerged in both the utilized databases and the detection methods. Adaptation of original screening tools was observed in 86.2% (50/58) of cases. Half of the original screening tools used for assessing PIMs belonged to the simple category. About a third of the studies employed less than half of the original criteria after adaptation. Only three studies used over 75% of the original criteria and more than 50 criteria. This extensive review highlights PIM prevalence among the older adults, emphasizing method intricacies and the potential for underestimation due to data limitations and algorithm adjustments. The findings call for enhanced methodologies, transparent algorithms and a deeper understanding of intricate rules' impact on public health implications.

Identifiants

pubmed: 38752677
doi: 10.1111/bcp.16092
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

Références

He W, Goodkind D, Kowal PR. An aging world: 2015. United States Census Bureau. 2016;165.
Gallagher P, Barry P, O'Mahony D. Inappropriate prescribing in the elderly. J Clin Pharm Ther. 2007;32(2):113‐121. doi:10.1111/j.1365‐2710.2007.00793.x
O'Connor MN, Gallagher P, O'Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging. 2012;29(6):437‐452. doi:10.2165/11632610‐000000000‐00000
Jano E, Aparasu RR. Healthcare outcomes associated with Beers' criteria: a systematic review. Ann Pharmacother. 2007;41(3):438‐448. doi:10.1345/aph.1H473
Spinewine A, Schmader KE, Barber N, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? The Lancet. 2007;370(9582):173‐184. doi:10.1016/S0140‐6736(07)61091‐5
Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community‐dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol. 2015;71(12):1415‐1427. doi:10.1007/s00228‐015‐1954‐4
Guaraldo L, Cano FG, Damasceno GS, Rozenfeld S. Inappropriate medication use among the elderly: a systematic review of administrative databases. BMC Geriatr. 2011;11(1):79. doi:10.1186/1471‐2318‐11‐79
By the 2023 American Geriatrics Society Beers criteria® update expert panel. American Geriatrics Society 2023 updated AGS Beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052‐2081. doi:10.1111/jgs.18372
O'Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):633. doi:10.1007/s41999‐023‐00812‐y
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097
Amann U, Schmedt N, Garbe E. Prescribing of potentially inappropriate medications for the elderly: an analysis based on the PRISCUS list. Dtsch Arzteblatt Int. 2012;109(5):69‐75.
Amos TB, Keith SW, Del Canale S, et al. Inappropriate prescribing in a large community‐dwelling older population: a focus on prevalence and how it relates to patient and physician characteristics. J Clin Pharm Ther. 2015;40(1):7‐13. doi:10.1111/jcpt.12212
Barnett MJ, Perry PJ, Langstaff JD, Kaboli PJ. Comparison of rates of potentially inappropriate medication use according to the Zhan criteria for VA versus private sector Medicare HMOs. J Manag Care Pharm. 2006;12(5):362‐370. doi:10.18553/jmcp.2006.12.5.362
Barnett K, McCowan C, Evans JMM, Gillespie ND, Davey PG, Fahey T. Prevalence and outcomes of use of potentially inappropriate medicines in older people: cohort study stratified by residence in nursing home or in the community. BMJ Qual Saf. 2011;20(3):275‐281. doi:10.1136/bmjqs.2009.039818
Bierman AS, Pugh MJV, Dhalla I, et al. Sex differences in inappropriate prescribing among elderly veterans. Am J Geriatr Pharmacother. 2007;5(2):147‐161. doi:10.1016/j.amjopharm.2007.06.005
Blozik E, Rapold R, von Overbeck J, Reich O. Polypharmacy and potentially inappropriate medication in the adult, community‐dwelling population in Switzerland. Drugs Aging. 2013;30(7):561‐568. doi:10.1007/s40266‐013‐0073‐0
Bongue B, Laroche ML, Gutton S, et al. Potentially inappropriate drug prescription in the elderly in France: a population‐based study from the French National Insurance Healthcare system. Eur J Clin Pharmacol. 2011;67(12):1291‐1299. doi:10.1007/s00228‐011‐1077‐5
Bradley MC, Fahey T, Cahir C, et al. Potentially inappropriate prescribing and cost outcomes for older people: a cross‐sectional study using the Northern Ireland enhanced prescribing database. Eur J Clin Pharmacol. 2012;68(10):1425‐1433. doi:10.1007/s00228‐012‐1249‐y
Bradley MC, Motterlini N, Padmanabhan S, et al. Potentially inappropriate prescribing among older people in the United Kingdom. BMC Geriatr. 2014;14(1):72. doi:10.1186/1471‐2318‐14‐72
Cahir C, Fahey T, Teeling M, Teljeur C, Feely J, Bennett K. Potentially inappropriate prescribing and cost outcomes for older people: a national population study. Br J Clin Pharmacol. 2010;69(5):543‐552. doi:10.1111/j.1365‐2125.2010.03628.x
Cahir C, Moriarty F, Teljeur C, Fahey T, Bennett K. Potentially inappropriate prescribing and vulnerability and hospitalization in older community‐dwelling patients. Ann Pharmacother. 2014;48(12):1546‐1554. doi:10.1177/1060028014552821
Carey IM, De Wilde S, Harris T, et al. What factors predict potentially inappropriate primary care prescribing in older people?: analysis of UK primary care patient record database. Drugs Aging. 2008;25(8):693‐706. doi:10.2165/00002512‐200825080‐00006
Clark CM, Shaver AL, Aurelio LA, et al. Potentially inappropriate medications are associated with increased healthcare utilization and costs. J Am Geriatr Soc. 2020;68(11):2542‐2550. doi:10.1111/jgs.16743
Curtis LH, Østbye T, Sendersky V, et al. Inappropriate prescribing for elderly Americans in a large outpatient population. Arch Intern Med. 2004;164(15):1621‐1625. doi:10.1001/archinte.164.15.1621
Davidoff AJ, Miller GE, Sarpong EM, Yang E, Brandt N, Fick DM. Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria. J Am Geriatr Soc. 2015;63(3):486‐500. doi:10.1111/jgs.13320
de Wilde S, Carey IM, Harris T, et al. Trends in potentially inappropriate prescribing amongst older UK primary care patients. Pharmacoepidemiol Drug Saf. 2007;16(6):658‐667. doi:10.1002/pds.1306
Fick DM, Mion LC, Beers MH, Waller J. Health outcomes associated with potentially inappropriate medication use in older adults. Res Nurs Health. 2008;31(1):42‐51. doi:10.1002/nur.20232
Fujie K, Kamei R, Araki R, Hashimoto K. Prescription of potentially inappropriate medications in elderly outpatients: a survey using 2015 Japanese guidelines. Int J Clin Pharmacol. 2020;42(2):579‐587. doi:10.1007/s11096‐020‐00967‐9
Futterman R, Fillit H, Roglieri JL. Use of ineffective or unsafe medications among members of a Medicare HMO compared to individuals in a Medicare fee‐for‐service program. Am J Manag Care. 1997;3(4):569‐575.
Grina D, Briedis V. The use of potentially inappropriate medications among the Lithuanian elderly according to Beers and EU(7)‐PIM list ‐ a nationwide cross‐sectional study on reimbursement claims data. J Clin Pharm Ther. 2017;42(2):195‐200. doi:10.1111/jcpt.12494
Goltz L, Kullak‐Ublick GA, Kirch W. Potentially inappropriate prescribing for elderly outpatients in Germany: a retrospective claims data analysis. Int J Clin Pharmacol Ther. 2012;50(3):185‐194. doi:10.5414/CP201441
Hedna K, Hakkarainen KM, Gyllensten H, Jönsson AK, Petzold M, Hägg S. Potentially inappropriate prescribing and adverse drug reactions in the elderly: a population‐based study. Eur J Clin Pharmacol. 2015;71(12):1525‐1533. doi:10.1007/s00228‐015‐1950‐8
Howard M, Dolovich L, Kaczorowski J, Sellors C, Sellors J. Prescribing of potentially inappropriate medications to elderly people. Fam Pract. 2004;21(3):244‐247. doi:10.1093/fampra/cmh305
Johnell K, Fastbom J, Rosén M, Leimanis A. Inappropriate drug use in the elderly: a nationwide register‐based study. Ann Pharmacother. 2007;41(7):1243‐1248. doi:10.1345/aph.1K154
Lai HY, Hwang SJ, Chen YC, Chen TJ, Lin MH, Chen LK. Prevalence of the prescribing of potentially inappropriate medications at ambulatory care visits by elderly patients covered by the Taiwanese National Health Insurance program. Clin Ther. 2009;31(8):1859‐1870. doi:10.1016/j.clinthera.2009.08.023
Leikola S, Dimitrow M, Lyles A, Pitkälä K, Airaksinen M. Potentially inappropriate medication use among Finnish non‐institutionalized people aged ≥65 years: a register‐based, cross‐sectional, national study. Drugs Aging. 2011;28(3):227‐236. doi:10.2165/11586890‐000000000‐00000
Lund BC, Carrel M, Gellad WF, Chrischilles EA, Kaboli PJ. Incidence‐ versus prevalence‐based measures of inappropriate prescribing in the veterans health administration. J Am Geriatr Soc. 2015;63(8):1601‐1607. doi:10.1111/jgs.13560
Maio V, Yuen EJ, Novielli K, Smith KD, Louis DZ. Potentially inappropriate medication prescribing for elderly outpatients in Emilia Romagna, Italy: a population‐based cohort study. Drugs Aging. 2006;23(11):915‐924. doi:10.2165/00002512‐200623110‐00006
Maio V, Del Canale S, Abouzaid S, Investigators GAP. Using explicit criteria to evaluate the quality of prescribing in elderly Italian outpatients: a cohort study. J Clin Pharm Ther. 2010;35(2):219‐229. doi:10.1111/j.1365‐2710.2009.01094.x
Mott DA, Meek PD. Evaluating prescriptions for the elderly: drug/age criteria as a tool to help community pharmacists. J Am Pharm Assoc. 1996;40(3):417‐424.
Nam YS, Han JS, Kim JY, Bae WK, Lee K. Prescription of potentially inappropriate medication in Korean older adults based on 2012 Beers criteria: a cross‐sectional population based study. BMC Geriatr. 2016;16(1):118. doi:10.1186/s12877‐016‐0285‐3
Nyborg G, Straand J, Brekke M. Inappropriate prescribing for the elderly—a modern epidemic? Eur J Clin Pharmacol. 2012;68(7):1085‐1094. doi:10.1007/s00228‐012‐1223‐8
Piecoro LT, Browning SR, Prince TS, Ranz TT, Scutchfield FD. A database analysis of potentially inappropriate drug use in an elderly Medicaid population. Pharmacotherapy. 2000;20(2):221‐228. doi:10.1592/phco.20.3.221.34779
Popović B, Quadranti NR, Matanović SM, et al. Potentially inappropriate prescribing in elderly outpatients in Croatia. Eur J Clin Pharmacol. 2014;70(6):737‐744. doi:10.1007/s00228‐014‐1667‐0
Pugh MJV, Fincke BG, Bierman AS, et al. Potentially inappropriate prescribing in elderly veterans: are we using the wrong drug, wrong dose, or wrong duration? J Am Geriatr Soc. 2005;53(8):1282‐1289. doi:10.1111/j.1532‐5415.2005.53402.x
Pugh MJV, Hanlon JT, Zeber JE, Bierman A, Cornell J, Berlowitz DR. Assessing potentially inappropriate prescribing in the elderly veterans affairs population using the HEDIS 2006 quality measure. J Manag Care Pharm. 2006;12(7):537‐545. doi:10.18553/jmcp.2006.12.7.537
Pugh MJV, Rosen AK, Montez‐Rath M, et al. Potentially inappropriate prescribing for the elderly: effects of geriatric care at the patient and health care system level. Med Care. 2008;46(2):167‐173. doi:10.1097/MLR.0b013e318158aec2
Reich O, Rosemann T, Rapold R, Blozik E, Senn O. Potentially inappropriate medication use in older patients in Swiss managed care plans: prevalence, determinants and association with hospitalization. PLoS ONE. 2014;9(8):e105425. doi:10.1371/journal.pone.0105425
Rigler SK, Perera S, Jachna C, Shireman TI, Eng M. Comparison of the association between disease burden and inappropriate medication use across three cohorts of older adults. Am J Geriatr Pharmacother. 2004;2(4):239‐247. doi:10.1016/j.amjopharm.2004.12.003
Roughead EE, Anderson B, Gilbert AL. Potentially inappropriate prescribing among Australian veterans and war widows/widowers. Intern Med J. 2007;37(6):402‐405. doi:10.1111/j.1445‐5994.2007.01316.x
Roux B, Sirois C, Simard M, Gagnon ME, Laroche ML. Potentially inappropriate medications in older adults: a population‐based cohort study. Fam Pract. 2020;37(2):173‐179. doi:10.1093/fampra/cmz060
Roux B, Bezin J, Morival C, Noize P, Laroche ML. Prevalence and direct costs of potentially inappropriate prescriptions in France: a population‐based study. Expert Rev Pharmacoecon Outcomes Res. 2022;22(4):627‐636. doi:10.1080/14737167.2021.1981863
Selke Krulichová I, Selke GW, Thürmann PA. Trends and patterns in EU(7)‐PIM prescribing to elderly patients in Germany. Eur J Clin Pharmacol. 2021;77(10):1553‐1561. doi:10.1007/s00228‐021‐03148‐3
Schubert I, Küpper‐Nybelen J, Ihle P, Thürmann P. Prescribing potentially inappropriate medication (PIM) in Germany's elderly as indicated by the PRISCUS list. An analysis based on regional claims data. Pharmacoepidemiol Drug Saf. 2013;22(7):719‐727. doi:10.1002/pds.3429
Simon SR, Chan KA, Soumerai SB, et al. Potentially inappropriate medication use by elderly persons in U.S. health maintenance organizations, 2000‐2001. J Am Geriatr Soc. 2005;53(2):227‐232.
Su S, Gao L, Ma W, et al. Number‐dependent association of potentially inappropriate medications with clinical outcomes and expenditures among community‐dwelling older adults: a population‐based cohort study. Br J Clin Pharmacol. 2022;88(7):3378‐3391. doi:10.1111/bcp.15286
van der Hooft CS, Jong GW, Dieleman JP, et al. Inappropriate drug prescribing in older adults: the updated 2002 Beers criteria–a population‐based cohort study. Br J Clin Pharmacol. 2005;60(2):137‐144. doi:10.1111/j.1365‐2125.2005.02391.x
Zuckerman IH, Langenberg P, Baumgarten M, et al. Inappropriate drug use and risk of transition to nursing homes among community‐dwelling older adults. Med Care. 2006;44(8):722‐730. doi:10.1097/01.mlr.0000215849.15769.be
Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003;163(22):2716‐2724. doi:10.1001/archinte.163.22.2716
Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Arch Intern Med. 1997;157(14):1531‐1536. doi:10.1001/archinte.1997.00440350031003
American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227‐2246.
Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA division of geriatric medicine. Arch Intern Med. 1991;151(9):1825‐1832. doi:10.1001/archinte.1991.00400090107019
American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616‐631.
2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674‐694.
Zhan C, Sangl J, Bierman AS, et al. Potentially inappropriate medication use in the community‐dwelling elderly: findings from the 1996 medical expenditure panel survey. JAMA. 2001;286(22):2823. doi:10.1001/jama.286.22.2823
Gallagher P, Ryan C, Byrne S, Kennedy J, O'Mahony D. STOPP (screening tool of older Person's prescriptions) and START (screening tool to alert doctors to right treatment). Consensus Validation Int J Clin Pharmacol Ther. 2008;46(2):72‐83. doi:10.5414/CPP46072
Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arzteblatt Int. 2010;107(31‐32):543‐551. doi:10.3238/arztebl.2010.0543
Renom‐Guiteras A, Meyer G, Thürmann PA. The EU(7)‐PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015;71(7):861‐875. doi:10.1007/s00228‐015‐1860‐9
Medication Management in Older Adults ‐ NCQA [Internet]. [cited 27 July 2023]. Disponible sur: https://www.ncqa.org/hedis/measures/medication-management-in-older-adults/
Fastbom J, Johnell K. National Indicators for quality of drug therapy in older persons: the Swedish experience from the first 10 years. Drugs Aging. 2015;32(3):189‐199. doi:10.1007/s40266‐015‐0242‐4
Kojima T, Mizukami K, Tomita N, et al. Screening tool for older persons' appropriate prescriptions for Japanese: report of the Japan geriatrics society working group on ‘guidelines for medical treatment and its safety in the elderly’: STOPP‐J. Geriatr Gerontol Int. 2016;16(9):983‐1001. doi:10.1111/ggi.12890
Laroche ML, Charmes JP, Merle L. Potentially inappropriate medications in the elderly: a French consensus panel list. Eur J Clin Pharmacol. 2007;63(8):725‐731. doi:10.1007/s00228‐007‐0324‐2
Roux B, Berthou‐Contreras J, Beuscart JB, et al. REview of potentially inappropriate MEDIcation pr[e]scribing in seniors (REMEDI[e]S): French implicit and explicit criteria. Eur J Clin Pharmacol. 2021;77(11):1713‐1724. doi:10.1007/s00228‐021‐03145‐6
Mimica Matanović S, Vlahovic‐Palcevski V. Potentially inappropriate medications in the elderly: a comprehensive protocol. Eur J Clin Pharmacol. 2012;68(8):1123‐1138. doi:10.1007/s00228‐012‐1238‐1
Rognstad S, Brekke M, Fetveit A, Spigset O, Wyller TB, Straand J. The Norwegian general practice (NORGEP) criteria for assessing potentially inappropriate prescriptions to elderly patients. A modified Delphi study. Scand J Prim Health Care. 2009;27(3):153‐159. doi:10.1080/02813430902992215
Shade MY, Berger AM, Chaperon C. Potentially inappropriate medications in community‐dwelling older adults. Res Gerontol Nurs. 2014;7(4):178‐192. doi:10.3928/19404921‐20140210‐01
Hill‐Taylor B, Sketris I, Hayden J, Byrne S, O'Sullivan D, Christie R. Application of the STOPP/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact. J Clin Pharm Ther. 2013;38(5):360‐372. doi:10.1111/jcpt.12059
Kush RD, Nordo AH. Data sharing and reuse of health data for research. In: Richesson RL, Andrews JE, eds. Clinical research informatics [Internet]. Springer International Publishing; 2019:379‐401. (Health Informatics). Disponible sur:. doi:10.1007/978‐3‐319‐98779‐8_18
Suissa S, Garbe E. Primer: administrative health databases in observational studies of drug effects—advantages and disadvantages. Nat Clin Pract Rheumatol. 2007;3(12):725‐732. doi:10.1038/ncprheum0652
Brown JS, Kahn M, Toh S. Data quality assessment for comparative effectiveness research in distributed data networks. Med Care. 2013;51(8 Suppl 3):S22‐S29. doi:10.1097/MLR.0b013e31829b1e2c
Tian F, Chen Z, Zeng Y, Feng Q, Chen X. Prevalence of use of potentially inappropriate medications among older adults worldwide: a systematic review and meta‐analysis. JAMA Netw Open. 2023;6(8):e2326910. doi:10.1001/jamanetworkopen.2023.26910

Auteurs

Romain Léguillon (R)

Department of Digital Health, Rouen University Hospital, Rouen, France.
Department of Pharmacy, Rouen University Hospital, Rouen, France.
Laboratoire D'Informatique Médicale et D'Ingénierie des Connaissances en e-Santé (LIMICS), U1142, INSERM, Sorbonne Université, Paris, France.

Julien Grosjean (J)

Department of Digital Health, Rouen University Hospital, Rouen, France.
Laboratoire D'Informatique Médicale et D'Ingénierie des Connaissances en e-Santé (LIMICS), U1142, INSERM, Sorbonne Université, Paris, France.

Frédéric Roca (F)

Normandy University, UniRouen, Inserm UMR1096 EnVI, FHU REMOD-VHF, Rouen, France.
Department of Geriatric Medicine, Rouen University Hospital, Rouen, France.

Eric Barat (E)

Department of Pharmacy, Rouen University Hospital, Rouen, France.
Normandie University, UNICAEN, Inserm U1086, Caen, France.

Rémi Varin (R)

Department of Pharmacy, Rouen University Hospital, Rouen, France.

Emeline Lejeune (E)

Department of Digital Health, Rouen University Hospital, Rouen, France.
Laboratoire D'Informatique Médicale et D'Ingénierie des Connaissances en e-Santé (LIMICS), U1142, INSERM, Sorbonne Université, Paris, France.

Gaëthan Kerdelhué (G)

Department of Digital Health, Rouen University Hospital, Rouen, France.
Laboratoire D'Informatique Médicale et D'Ingénierie des Connaissances en e-Santé (LIMICS), U1142, INSERM, Sorbonne Université, Paris, France.

Stéfan Darmoni (S)

Department of Digital Health, Rouen University Hospital, Rouen, France.
Laboratoire D'Informatique Médicale et D'Ingénierie des Connaissances en e-Santé (LIMICS), U1142, INSERM, Sorbonne Université, Paris, France.

Jean Charlet (J)

Laboratoire D'Informatique Médicale et D'Ingénierie des Connaissances en e-Santé (LIMICS), U1142, INSERM, Sorbonne Université, Paris, France.

Marie Laure Laroche (ML)

VieSanté Unit - UR 24134, Omega Health Institut, Limoges University, Limoges, France.
Pharmacovigilance and Pharmacoepidemiology Center, Limoges University Hospital, Limoges, France.

Classifications MeSH