Inappropriate prescribing in the elderly.

Hdl Handle:
http://hdl.handle.net/10147/209285
Title:
Inappropriate prescribing in the elderly.
Authors:
Gallagher, P; Barry, P; O'Mahony, D
Affiliation:
Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork,, Ireland.
Citation:
J Clin Pharm Ther. 2007 Apr;32(2):113-21.
Journal:
Journal of clinical pharmacy and therapeutics
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209285
DOI:
10.1111/j.1365-2710.2007.00793.x
PubMed ID:
17381661
Abstract:
BACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: 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.
Language:
eng
MeSH:
Aged; Clinical Pharmacy Information Systems/statistics & numerical data; Drug Utilization Review/methods/statistics & numerical data; Health Services for the Aged/standards/statistics & numerical data; Humans; Medication Errors/statistics & numerical data; Pharmaceutical Preparations/*adverse effects; *Physician's Practice Patterns
ISSN:
0269-4727 (Print); 0269-4727 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorGallagher, Pen_GB
dc.contributor.authorBarry, Pen_GB
dc.contributor.authorO'Mahony, Den_GB
dc.date.accessioned2012-02-03T15:17:12Z-
dc.date.available2012-02-03T15:17:12Z-
dc.date.issued2012-02-03T15:17:12Z-
dc.identifier.citationJ Clin Pharm Ther. 2007 Apr;32(2):113-21.en_GB
dc.identifier.issn0269-4727 (Print)en_GB
dc.identifier.issn0269-4727 (Linking)en_GB
dc.identifier.pmid17381661en_GB
dc.identifier.doi10.1111/j.1365-2710.2007.00793.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/209285-
dc.description.abstractBACKGROUND AND OBJECTIVE: Drug therapy is necessary to treat acute illness, maintain current health and prevent further decline. However, optimizing drug therapy for older patients is challenging and sometimes, drug therapy can do more harm than good. Drug utilization review tools can highlight instances of potentially inappropriate prescribing to those involved in elderly pharmacotherapy, i.e. doctors, nurses and pharmacists. We aim to provide a review of the literature on potentially inappropriate prescribing in the elderly and also to review the explicit criteria that have been designed to detect potentially inappropriate prescribing in the elderly. METHODS: We performed an electronic search of the PUBMED database for articles published between 1991 and 2006 and a manual search through major journals for articles referenced in those located through PUBMED. Search terms were elderly, inappropriate prescribing, prescriptions, prevalence, Beers criteria, health outcomes and Europe. RESULTS AND DISCUSSION: Prescription of potentially inappropriate medications to older people is highly prevalent in the United States and Europe, ranging from 12% in community-dwelling elderly to 40% in nursing home residents. Inappropriate prescribing is associated with adverse drug events. Limited data exists on health outcomes from use of inappropriate medications. There are no prospective randomized controlled studies that test the tangible clinical benefit to patients of using drug utilization review tools. Existing drug utilization review tools have been designed on the basis of North American and Canadian drug formularies and may not be appropriate for use in European countries because of the differences in national drug formularies and prescribing attitudes. CONCLUSION: 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.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshClinical Pharmacy Information Systems/statistics & numerical dataen_GB
dc.subject.meshDrug Utilization Review/methods/statistics & numerical dataen_GB
dc.subject.meshHealth Services for the Aged/standards/statistics & numerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMedication Errors/statistics & numerical dataen_GB
dc.subject.meshPharmaceutical Preparations/*adverse effectsen_GB
dc.subject.mesh*Physician's Practice Patternsen_GB
dc.titleInappropriate prescribing in the elderly.en_GB
dc.contributor.departmentDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork,, Ireland.en_GB
dc.identifier.journalJournal of clinical pharmacy and therapeuticsen_GB
dc.description.provinceMunster-
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