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The use of the Meds75+ database in healthcare improves the medication safety of the elderly

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The purpose of the national Meds75+ database maintained by Fimea is to support clinical decision-making concerning the pharmacotherapy of the elderly and to improve medication safety in primary healthcare. The database contains a classification (A-D) and a recommendation for almost 450 medicinal substances or their combinations.

Category Category description
A Suitable for older persons. The medicinal substance can be used as in younger patients. Changes due to aging do not affect the dose or frequency of administration. The adverse reaction profile is not different from that of younger patients.
B There is little research evidence, practical experience or efficacy in older persons.
C Suitable for older persons, with specific cautions. The medicinal substance can be used with caution. The changes due to aging on the dose or frequency of administration must be taken into account when used. The effects of the renal function on pharmacotherapy must also be considered. The use of the medicine may involve a significant risk of adverse reaction or interaction.
D Avoid use in older persons. The risk of adverse reactions typically exceeds the clinical benefits. Use is only possible in exceptional cases or on a one-off basis.

The recommendations on medicinal substances are based on the joint view of a working group composed of professionals in the field of the pharmacotherapy of the elderly. The working group includes, among others, specialists in geriatrics, pharmacists, and clinical pharmacology specialists from all over Finland. The assessment makes use of international recommendations, adverse reaction and interaction databases, and the latest research data.

The database is primarily intended for use by healthcare professionals.  The database is also available for the elderly and their next of kin free of charge via the FimeaWeb medicines search service in Finnish, Swedish and English.

The use of the Meds75+ information in healthcare was promoted in a variety of ways

During 2020, the Meds75+ working group put special focus on improving the content and update process of the database and on promoting the use of the database in healthcare.

The most significant upgrade was the integration of the former Meds75+ search as part of the general FimeaWeb medicines search service. As a result of the upgrade, the Meds75+ recommendation will appear in all FimeaWeb search results, contributing to the increased visibility and use of the database. Healthcare professionals can also use the database via the “Vanhus ja lääke” (The elderly and medicines) section of the medicines database maintained by the Finnish Medical Society Duodecim. In pharmacies, on the other hand, the database is used via the Salko database maintained by the Association of Finnish Pharmacies.

The working group has engaged and will engage in collaboration at the national level with software developers who have been willing to integrate the database as part of the pharmacotherapy software they have developed. 

Awareness of the database is also promoted by means of communications. During the year, we prepared national and international articles, some of which have already been published while others are pending publication in the next year because of the review processes.

Positive experiences from the Meds75+ database in healthcare

The Meds75+ database has proven a fast and easy-to-use tool that is actively used by healthcare professionals to ensure the safety of medicines. The database is clear and intuitive and provides information in a concise format on the suitability of the medicinal product for use by the elderly

Based on the feedback received, the use of the Meds75+ database supports clinical decision-making in healthcare relating to the pharmacotherapy of the elderly and contributes to the improvement of medication safety in primary health care.

“I work as a department pharmacist at the Kuopio University Hospital and use the Meds75+ database every day in my work. The Meds75+ database is clear and intuitive and explains why a specific medicine is or is not recommended for the elderly. Whenever I enter comments for physicians, I also include the Meds75+ recommendation. Our pharmaceutical professionals make frequent use of the Meds75+ database when carrying out safety checks on medications.

In my experience, other healthcare professionals only use the database occasionally. The Meds75+ recommendation is currently also displayed in the Terveysportti health portal directly next to the medicine, which has made it easier to use. In my opinion, the use of the database should indeed be further increased in healthcare to improve the medication safety of the elderly.”
-Anu Ahonen, Department Pharmacist, Kuopio University Hospital