Inappropriate prescribing in the elderly

Abstract

Given the high prevalence of inappropriate prescribing despite the widespread use of drug-utilization review tools, prospective randomized controlled trials are necessary to identify useful interventions. Drug utilization review tools should be designed on the basis of a country's national drug formulary and should be evidence based.

Pattern of medication use among elderly patients attending medicine department in a tertiary care hospital in India

“…Polypharmacy in elderly patients exposes them to increased drug interactions, increased adverse drug reactions (ADRs), and increased health care cost [6]. ADRs are more prevalent in elderly and most are type A reactions predictable from the known pharmacology of the drug and are mostly avoidable [7][8][9].…”

‘Appropriateness’ in Italy: A ‘Magic Word’ in Pharmaceuticals?

“…With the aim of clarifying the meaning of appropriateness in the context of pharmaceutical prescription and find a justification for its recent mention in the INHS, we conducted an international literature search on the PubMed international database 1 and identified six studies containing a theoretical definition of this term [6][7][8][9][10][11].…”

“…Drug safety (relating to risk-benefit) was mentioned in five [6-8, 10, 11] of the six studies selected; among these, three each included drug efficacy [7,10,11] and cost effectiveness [7,8,11] as further issues, and only two each considered prescription patterns [8,10] and patients' choices [7,11]. The remaining study [9] mentioned only prescription patterns.…”

“…Kaufmann et al [7] and Lexchin (the most dated among the studies reviewed) [11] considered all the key issues except prescription patterns, underlining the importance of maximizing efficacy and minimizing risks and costs while still respecting patients' preferences. O'Connor et al [8] and Gallagher et al [10] attributed inappropriate prescribing mainly to safety and prescription patterns; the latter pointed out the role of efficacy too, while the former added the issue of cost-effectiveness. The remaining two studies included only one of the five key issues.…”

Prävalenz und Verordnungsentwicklung von PRISCUS-Medikamenten und fraglichen PRISCUS-Medikamenten – Ergebnisse der populationsbasierten Heinz Nixdorf Recall Studie

“…Daneben kann ein Arzneimittel auch potenziell inadäquat sein, wenn es entweder bei bestimmten Diagnosen oder in bestimmten Dosierungen bei Älteren vermieden werden soll (Gallagher et al 2007). Es gibt implizite und explizite Kriterien um PIM zu detektieren (Thiem 2012).…”