Inappropriate prescribing and adverse drug events in older people.

Hdl Handle:
http://hdl.handle.net/10147/201236
Title:
Inappropriate prescribing and adverse drug events in older people.
Authors:
Hamilton, Hilary J; Gallagher, Paul F; O'Mahony, Denis
Affiliation:
Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland. hilaryjaneh@yahoo.com
Citation:
Inappropriate prescribing and adverse drug events in older people. 2009, 9:5 BMC Geriatr
Journal:
BMC geriatrics
Issue Date:
2009
URI:
http://hdl.handle.net/10147/201236
DOI:
10.1186/1471-2318-9-5
PubMed ID:
19175914
Additional Links:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642820/pdf/1471-2318-9-5.pdf; http://www.biomedcentral.com/content/pdf/1471-2318-9-5.pdf
Abstract:
Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
Item Type:
Article
Language:
en
Description:
Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.
MeSH:
Aged; Drug Prescriptions; Drug Utilization; Humans; Medication Errors; Pharmaceutical Preparations
ISSN:
1471-2318

Full metadata record

DC FieldValue Language
dc.contributor.authorHamilton, Hilary Jen
dc.contributor.authorGallagher, Paul Fen
dc.contributor.authorO'Mahony, Denisen
dc.date.accessioned2012-01-10T12:02:29Z-
dc.date.available2012-01-10T12:02:29Z-
dc.date.issued2009-
dc.identifier.citationInappropriate prescribing and adverse drug events in older people. 2009, 9:5 BMC Geriatren
dc.identifier.issn1471-2318-
dc.identifier.pmid19175914-
dc.identifier.doi10.1186/1471-2318-9-5-
dc.identifier.urihttp://hdl.handle.net/10147/201236-
dc.descriptionInappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.en
dc.description.abstractInappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.-
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2642820/pdf/1471-2318-9-5.pdfen
dc.relation.urlhttp://www.biomedcentral.com/content/pdf/1471-2318-9-5.pdfen
dc.subject.meshAged-
dc.subject.meshDrug Prescriptions-
dc.subject.meshDrug Utilization-
dc.subject.meshHumans-
dc.subject.meshMedication Errors-
dc.subject.meshPharmaceutical Preparations-
dc.titleInappropriate prescribing and adverse drug events in older people.en
dc.typeArticleen
dc.contributor.departmentDepartment of Geriatric Medicine, Cork University Hospital, Cork, Ireland. hilaryjaneh@yahoo.comen
dc.identifier.journalBMC geriatricsen
dc.description.provinceMunster-

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