Identifying Inappropriate Prescribing for Older People

Elliott, Rohan A; Stehlik, Paulina

doi:10.1002/j.2055-2335.2013.tb00284.x

Cited by 11 publications

(17 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, most of the tools lack consideration of dose as well as renal function and other patient characteristics and many have only been validated or tested in certain populations. Explicit PIMs lists do not take into account the individual patient’s situation and as such a significant proportion of medications identified using these tools may be ‘appropriate’ and not suitable for deprescribing . Additionally, they generally do not provide guidance on what to do once a potentially inappropriate medication has been identified or how to prioritise clinical decisions …”

Section: Tools To Aid In Specific Parts Of the Deprescribing Processmentioning

confidence: 99%

“…Explicit PIMs lists do not take into account the individual patient's situation and as such a significant proportion of medications identified using these tools may be 'appropriate' and not suitable for deprescribing. 49 Additionally, they generally do not provide guidance on what to do once a potentially inappropriate medication has been identified or how to prioritise clinical decisions. 46 The Good Palliative-Geriatric Practice (GP-GP) algorithm is an implicit tool, designed to guide clinicians through determining appropriateness of a medication and provide advice on whether to stop the medication, reduce the dose, continue the medication or switch to an alternative.…”

Section: Tools For Identifying Potentially Inappropriate Medications mentioning

confidence: 99%

See 1 more Smart Citation

Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice

Reeve

2020

Pharmacy Practice and Res

View full text Add to dashboard Cite

The importance of deprescribing, which is the process of withdrawing an inappropriate medication, supervised by a healthcare professional with the goal of managing polypharmacy and improving outcomes, is increasingly recognised as part of good clinical care. With this, a number of tools have been developed with the purpose of aiding health professionals to deprescribe in regular practice. The types of tools vary significantly in their form and include tools to aid in the overall process of deprescribing (such as generic frameworks and drug‐specific deprescribing guidelines) as well as tools that may assist in a specific part of the process (such as identifying inappropriate medications or engaging the patient). While many tools are available, most provide little (if any) information on how they were developed, and limited implementation research has been conducted. This paper provides an overview of the types of available tools and how they might be used in clinical practice.

show abstract

Section: Tools To Aid In Specific Parts Of the Deprescribing Processmentioning

confidence: 99%

Section: Tools For Identifying Potentially Inappropriate Medications mentioning

confidence: 99%

Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice

Reeve

2020

Pharmacy Practice and Res

View full text Add to dashboard Cite

show abstract

“…Indeed, many other lists are derived from the Beers Criteria . Crucially, they are the only criteria where the strength of evidence for recommendations is reported . The applicability of the Beers Criteria across care settings and in Europe has increased with updates .…”

Section: Introductionmentioning

confidence: 99%

Do the 2015 Beers Criteria predict medication‐related harm in older adults? Analysis from a multicentre prospective study in the United Kingdom

Parekh

Ali

Davies

et al. 2019

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

Purpose To investigate whether inappropriate prescribing, defined by the Beers Criteria, is associated with medication‐related harm (MRH), hospital admission, and mortality in older adults in England. Methods A multicentre, prospective cohort study recruited 1280 patients (median age 82 years) at hospital discharge. Patients were followed‐up in the community by pharmacists for 8 weeks to identify MRH (harm from adverse drug reactions, non‐adherence, and medication errors) and hospital admissions. One‐year mortality was determined using hospital records. Potentially inappropriate medications (PIMs) were determined using the 2015 version of the Beers criteria. Logistic regression was used to investigate the relationship between patients prescribed PIMs and adverse outcomes. Results Two hundred and seventy‐six patients (22%) were prescribed one or more PIMs at hospital discharge. The main PIM classes prescribed at hospital discharge were benzodiazepines and related drugs (30%) and antidepressants (27%). 1116 out of 1280 patients completed follow‐up and 413 (37%) experienced MRH. In 51 cases (12%), MRH was attributable to a PIM. There was no significant relationship between patients prescribed PIMs and overall MRH, hospital readmission or all‐cause one‐year mortality. Multiple PIMs at discharge was independently associated with an increased risk of ADR (OR 2.32, 95% CI 1.03‐5.23). Conclusion The prescribing of PIMs is common at hospital discharge of older adults in England. The 2015 Beers criteria have a limited clinical value to predict adverse outcomes following hospital discharge in this setting.

show abstract

“…Building on that seminal 2003 article, over the next 10 years several Geriatric Therapeutics articles related to deprescribing were published. These addressed identifying potentially inappropriate medications, ethical issues associated with prescribing for the elderly, and end of life prescribing …”

Section: Early Articles and Changes In Therapeutics Over The Last 30 mentioning

confidence: 99%

“…These addressed identifying potentially inappropriate medications, ethical issues associated with prescribing for the elderly, and end of life prescribing. [41][42][43][44] In 2006, and again in 2014, updates of Fonda's 1986 article on 'problems with drug use' were published. 28,45 These articles reviewed Australian literature and highlighted increasing prevalence and magnitude of polypharmacy and ADRs in older people.…”

Section: Improving Medication Outcomes For Older Peoplementioning

confidence: 99%

Thirty years of Geriatric Therapeutics

Elliott

Woodward

2016

Pharmacy Practice and Res

View full text Add to dashboard Cite

In the 1980s geriatric medicine was in its infancy in Australia, and geriatric therapeutics was a newly developing field. There was little primary literature regarding geriatric pharmacology and pharmacotherapy in older people. The Heidelberg Repatriation Hospital in Melbourne appointed its first geriatrician in 1983, and the ‘Geriatric Therapeutics’ series of articles (now known as ‘Geriatric Therapeutics Review’) began in 1986, as a partnership between the hospital's Pharmacy and Aged and Extended Care departments. Until 1990 Geriatric Therapeutics articles were published in the hospital's Pharmacy Bulletin. Since 1991 they have been published in this journal. For 30 years the series has provided readers with contemporary reviews of the management of medical problems in older people, with an emphasis on rational and safe drug therapy. Over that period there have been considerable changes in the therapeutic management of diseases that commonly affect older people, and the 125 articles published between 1986 and 2016 reflect many of those changes. To commemorate the 30th Anniversary of the Geriatric Therapeutics series, this article describes its origins and development, and some of the changes in therapeutics that have occurred over the last 30 years.

show abstract

Identifying Inappropriate Prescribing for Older People

Cited by 11 publications

References 77 publications

Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice

Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice

Do the 2015 Beers Criteria predict medication‐related harm in older adults? Analysis from a multicentre prospective study in the United Kingdom

Thirty years of Geriatric Therapeutics

Contact Info

Product

Resources

About