Inappropriate prescribing and adverse drug events in older people

Hdl Handle:
http://hdl.handle.net/10147/567064
Title:
Inappropriate prescribing and adverse drug events in older people
Authors:
Hamilton, Hilary J; Gallagher, Paul F; O'Mahony, Denis
Citation:
BMC Geriatrics. 2009 Jan 28;9(1):5
Issue Date:
28-Jan-2009
URI:
http://dx.doi.org/10.1186/1471-2318-9-5; http://hdl.handle.net/10147/567064
Abstract:
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.
Language:
en
Keywords:
MEDICINES; PRESCRIBING; OLDER PEOPLE

Full metadata record

DC FieldValue Language
dc.contributor.authorHamilton, Hilary Jen
dc.contributor.authorGallagher, Paul Fen
dc.contributor.authorO'Mahony, Denisen
dc.date.accessioned2015-08-17T08:47:58Zen
dc.date.available2015-08-17T08:47:58Zen
dc.date.issued2009-01-28en
dc.identifier.citationBMC Geriatrics. 2009 Jan 28;9(1):5en
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2318-9-5en
dc.identifier.urihttp://hdl.handle.net/10147/567064en
dc.description.abstractAbstract 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.en
dc.language.isoenen
dc.subjectMEDICINESen
dc.subjectPRESCRIBINGen
dc.subjectOLDER PEOPLEen
dc.titleInappropriate prescribing and adverse drug events in older peopleen
dc.language.rfc3066enen
dc.rights.holderHamilton et al.en
dc.date.updated2015-08-14T13:23:15Zen
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.