title: Clinical medication review tool for polypharmacy: Mapping approach for pharmacotherapeutic classifications.
abstract: OBJECTIVE
  Polypharmacy is an extremely important problem, because it increases the risk of adverse drug reactions. The aim of the current study was to create a clinical medication review tool to detect inappropriate medication use, and assess this new method with elderly Japanese patients.
  
  
  METHODS
  The new method involves optimizing prescription drugs from indications, based on the chronic disease-anatomical therapeutic class code list. The present study investigated the prevalence of potentially inappropriate medications in 5667 Japanese patients aged ≥65 years with polypharmacy (≥5 drugs) in comparison with the Beers criteria 2012.
  
  
  RESULTS
  We propose a new method called the Mapping Approach for Pharmacotherapeutic Classifications: (i) identify the chronic disease-anatomical therapeutic class code assigned to the prescription drugs; (ii) identify the chronic disease-anatomical therapeutic class code corresponding to the patient's chronic disease; (iii) compare the prescription drug and patient's chronic disease chronic disease-anatomical therapeutic class codes; and (iv) identify the appropriateness of medication use based on the comparison (appropriate use is defined as matching codes). The mean number of potentially inappropriate medications detected was significantly different between the mapping approach and Beers criteria 2012 (3.1 ± 2.6 vs 0.6 ± 0.8 drugs, respectively; P < 0.001).
  
  
  CONCLUSIONS
  The Mapping Approach for Pharmacotherapeutic Classifications is highly dependent on the chronic condition. Pharmacists should confirm the chronic condition with the treating physician before reducing a patient's medications. We hope this process will further influence prescribing patterns, and decrease the inappropriate use of medications and associated adverse drug reactions in older adults. Geriatr Gerontol Int 2017; 17: 2025-2033.
authors.affiliation: Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Fumihiro
authors.identifier: http://orcid.org/0000-0003-2732-7786
authors.initials: F
authors.lastname: Mizokami
authors.affiliation: Analytical Pharmacology, Meijo University Graduate School of Pharmacy, Nagoya, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Analytical Pharmacology, Meijo University Graduate School of Pharmacy, Nagoya, Japan.
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Mori
authors.affiliation: Analytical Pharmacology, Meijo University Graduate School of Pharmacy, Nagoya, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nagamatsu
authors.affiliation: Department of Pharmacy, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Endo
authors.affiliation: Department of Pharmacy, Gifu Prefectural General Medical Center, Gifu, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hirashita
authors.affiliation: Department of Pharmacy, Mie Chuo Medical Center, Tsu, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Ichino
authors.affiliation: Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Akishita
authors.affiliation: Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan.|Pressure Ulcer Care Center, Kobayashi Health Care System Kobayashi Memorial Hospital, Hekinan, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furuta
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D007564:Japan; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List
keywords: inappropriate medication use; mapping approach for pharmacotherapeutic classifications; polypharmacypotentially inappropriate medication