(ASPOT44) De-Med: Developing a Tool for Identifying and Categorizing Potentially Inappropriate Medications in the Elderly Using Beers Criteria, STOPP, and FORTA - A Cross-Sectional Study

Background: The prescription of potentially inappropriate medications (PIMs) in older adults contributes to adverse outcomes including increased risk of physical and cognitive decline, hospitalizations, and mortality.

Objectives: The aim of this study was to create and evaluate the De-Med tool for its reliability and practicality in identifying PIMs.

Methods: Developed with ReactJS for efficient data handling, the De-Med tool allows for the uploading and analysis of medication lists, identifying PIMs based on the Beers Criteria 2019, the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) Version 2, and the Fit for The Aged (FORTA) 2021 standards. Its reliability was tested by comparing the tool's findings against manual evaluations by independent pharmacy researchers using historical medication data. The System Usability Scale and the AttrakDiff Mini questionnaire assessed the tool's feasibility and user-friendliness, respectively.

Results: A total of 231 patient medication data were extracted, including 133 (58%) males and 98 (42%) females, with a mean age of 72.91 ± 6.67 years. A total of 1496 PIMs were identified, with a mean of 0.63 ± 0.49 per encounter. There was a perfect match between manual evaluations and the tool's identification of PIMs, indicating a 100% reliability rate. The software's usability was evaluated by 20 clinical pharmacists using the System Usability Scale (SUS) and AttrakDiff questionnaire. The SUS score of 83.75 indicated excellent usability, suggesting that users would frequently use and recommend the software. The AttrakDiff revealed moderate pragmatic quality (mean 1.84 ± 0.29), hedonic quality (mean 1.50 ± 0.31), and overall attractiveness (mean 2.13). These findings demonstrate the software's potential for PIM identification and positive user experience ratings, supporting its feasibility and usability in clinical practice.

Conclusions: The De-Med web-based tool demonstrated flawless reliability in identifying PIMs, along with high usability and moderate attractiveness. It shows promise for enhancing medication safety in the elderly by minimizing the use of PIMs.