Adverse Reactions/Medication Safety: Beyond the Beers Criteria: A Comparative Overview of Explicit Criteria

Levy, Hedva Barenholtz; Marcus, Esther‐Lee; Christen, Catherine

doi:10.1345/aph.1p426

Cited by 99 publications

(86 citation statements)

References 21 publications

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“…It is a tool designed for use in USA; therefore, many of the medications on its list are not available in Europe 18. It omits many commonly used drugs in Europe and does not address drug–drug interactions, drug duplications or drug omissions19 which highlights issues of its applicability in a UK setting.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of potentially inappropriate medication prescribing in elderly patients with chronic kidney disease

Jones

Bhandari

2013

Postgraduate Medical Journal

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Introduction Potentially inappropriate medication (PIM) prescribing is a global problem. Limited data are available on the prevalence of PIMs in elderly patients with chronic kidney disease (CKD). We examined the PIM prevalence in elderly patients with CKD, the most common drugs implicated and the levels of polypharmacy in this group. Methods A retrospective case record analysis of patients with CKD above the age of 70 years was carried out on 100 consecutive inpatients between January 2008 and June 2008 at a University Teaching Hospital. PIMs were defined using the modified Beers' criteria and latest British National Formulary (BNF) guidance for prescribing in patients with renal impairment using creatinine clearance calculated by the Cockroft–Gault formula. Results The mean age of the cohort was 80 years with a female predominance (62%). The mean estimated glomerular filtration rate (eGFR) was 17.2 ml/min/1.73 m2. 56 patients had one or more PIMs prescribed during the acute admission period. 81 out of the 622 medications prescribed were ‘inappropriate’; therefore, the prevalence of PIMs prescribed was 13%. Antibiotics and antihypertensives accounted for the majority of PIMs. Each patient received an average of six drugs. Conclusions The prevalence of PIMs in elderly inpatients with CKD is high. Inclusion of drugs prescribed acutely and use of the BNF to identify PIMs as well as the Beers' criteria may account for this. Use of screening tools may lead to better identification of PIMs in this high risk group. Routine calculation and documentation of eGFR on the medication chart on admission may help reduce PIMs.

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Section: Discussionmentioning

confidence: 99%

The prevalence of potentially inappropriate medication prescribing in elderly patients with chronic kidney disease

Jones

Bhandari

2013

Postgraduate Medical Journal

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“…According to different authors, newer criteria offer certain innovations and improvements compared to those on the original Beers list and address drug-drug interactions, underuse of drugs, drugs with questionable efficacy, among others [18][19][20]. However, while several new tools need to be evaluated and assessed in clinical studies, Beers criteria have been the most widely used and an association of the listed drugs with adverse outcomes has been shown by number of authors [21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”

Section: Introductionmentioning

confidence: 99%

Potentially inappropriate medications in the elderly: a comprehensive protocol

Matanović

Vlahović‐Palčevski

2012

Eur J Clin Pharmacol

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Elderly patients are at increased risk of drug-related morbidity and mortality. Avoiding the use of potentially inappropriate medications (PIMs) is one of the strategies that has been widely adopted to reduce the harmful consequences of drug use. There are several PIM screening tools available. In this review, we provide an overview of existing screening tools to detect PIMs in the elderly, emphasizing the advantages and disadvantages of each. Combining previously published and adopted tools (adjusted Beers list, French consensus panel, McLeod's list, and Lindblad's list of clinically important drug-disease interactions), we develop a new comprehensive tool that also includes the adjusted Hanlon's and Malone's lists of potentially serious drug-drug interactions in the elderly. In addition to listed PIMs and clinically important drug-drug interactions, alternative therapeutic solutions are suggested. The new protocol differentiates: drugs with an unfavorable benefit/risk ratio (to be avoided regardless of the underlying disease/condition), drugs with a questionable efficacy, and drugs to be avoided with certain diseases/conditions, and provides a list of potentially serious drug-drug interactions. A tool consisting of PIMs and potential drug-drug interactions within the same protocol provides more comprehensive quality assessment of drug-prescribing behavior to the elderly, which in turn may lead to better prescribing practices.

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“…B. der Beers-Liste [7,8]. Diese führt potenziell gefährliche Medikamente (PIMs) auf und wird kontinuierlich aktualisiert [9].…”

Section: Klassifikationssystemeunclassified

Polypharmazie im Alter – klug entscheiden mit dem FORTA-Prinzip

Wehling

Throm

2015

Dtsch Med Wochenschr

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Multimorbidity and polypharmacy are threats to elderly patients; improvement of medication is important and a novel listing approach - the FORTA [Fit fOR The Aged] list - should support this in clinical practice. Here, we aim to describe procedural details of successful application of FORTA. FORTA labels range from A (indispensable), B (beneficial), C (questionable) to D (avoid), depending on evidence for safety, efficacy and overall age-appropriateness. As an implicit tool, it is only applicable if medical details of the patient are known. The process starts with history taking and diagnostic assessment including disease grading. This is the base for FORTA-assisted selection of drugs to avoid overtreatment (drug not necessary), undertreatment (condition not or not sufficiently treated by positively labeled drugs) or mistreatment (drugs indicated, but negatively rather than positively labeled drug chosen). Selection is followed by secondary analyses, e. g. regarding dosing or contraindications. The medication scheme is updated in reflection of wanted clinical effects (e. g. blood pressure lowering) and side effects (e. g. dizziness).

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Adverse Reactions/Medication Safety: Beyond the Beers Criteria: A Comparative Overview of Explicit Criteria

Cited by 99 publications

References 21 publications

The prevalence of potentially inappropriate medication prescribing in elderly patients with chronic kidney disease

The prevalence of potentially inappropriate medication prescribing in elderly patients with chronic kidney disease

Potentially inappropriate medications in the elderly: a comprehensive protocol

Polypharmazie im Alter – klug entscheiden mit dem FORTA-Prinzip

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