Development of explicit definitions of potentially inappropriate prescriptions for antidiabetic drugs in people with type 2 diabetes: A Delphi survey and consensus meeting

INTRODUCTION: Explicit definitions for potentially inappropriate prescriptions (PIPs) are useful for optimizing drug use. The objective of the present study was to validate a list of definitions of PIPs for antidiabetic drugs in a Delphi survey with general practitioners, diabetologists, community pharmacists, hospital pharmacists and pharmacologists from mainland France, Belgium, and Switzerland. METHODS: The experts gave their opinion on each explicit definition and could suggest new definitions. Definitions with a 1-to-9 Likert score of between 7 and 9 from at least 75% of the participants were validated. The results were discussed during consensus meetings after each round. RESULTS: 46 participants were recruited, and 38 (82.6%) completed the survey. The Delphi survey resulted in a consensus list of 41 explicit definitions of PIPs for antidiabetic drugs in four groups: (i) the need to temporarily discontinue a medication in the event of acute illness (n = 9; 22%), (ii) the need to review and adjust the dosing regimen (n = 26; 36.6%), (iii) the initiation of an inappropriate drug (n = 3; 7.3%), and (iv) the need for further monitoring of a people with type 2 diabetes (n = 3; 7.3%). CONCLUSIONS: The list is specific for antidiabetic drugs (other than insulin) for people with type 2 diabetes. This explicit list could be implemented in a clinical decision support system for the automatic detection of PIPs and might help healthcare professionals involved in the management of people living with type 2 diabetes.