Open AccessJournal Article
Defining inappropriate practices in prescribing for elderly people: a national consensus panel
TLDR
The authors have developed a valid, relevant list of inappropriate practices in prescribing for elderly people, to be used in a practice-based intervention study.Abstract:
OBJECTIVE: To develop a consensus-based list of inappropriate practices in prescribing for elderly people. DESIGN: Mail survey of a 32-member national panel. SETTING: Academic medical centres across Canada. PARTICIPANTS: Thirty-two specialists selected arbitrarily, including 7 clinical pharmacologists, 9 geriatricians, 8 family practitioners and 8 pharmacists. OUTCOME MEASURES: Consensus that the practice would introduce a substantial and significant increase in the risk of serious adverse effect and is common enough that its curtailment would decrease morbidity among elderly people, ranking of clinical importance of the risk, and availability of equally or more effective and less risky alternative therapy. RESULTS: The 32-member national panel developed a list of 71 practices in prescribing for elderly people and rated the clinical significance of each on a scale of 1 (not significant) to 4 (highly significant). The practices in prescribing identified fell into 3 categories: drugs generally contraindicated for elderly people, drug-disease interactions and drug-drug interactions. The mean significance rating was greater than 3 for 39 practices. For each practice, alternative therapies were recommended. There was surprising congruence among the specialists on the significance rating and the suggested alternative therapies. CONCLUSION: The authors have developed a valid, relevant list of inappropriate practices in prescribing for elderly people, to be used in a practice-based intervention study.read more
Citations
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Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts.
Donna M. Fick,James W. Cooper,William E. Wade,Jennifer L. Waller,J. Ross Maclean,Mark H. Beers +5 more
TL;DR: The application of the Beers criteria and other tools for identifying potentially inappropriate medication use will continue to enable providers to plan interventions for decreasing both drug-related costs and overall costs and thus minimize drug- related problems.
Journal ArticleDOI
Appropriate prescribing in elderly people: how well can it be measured and optimised?
Anne Spinewine,Kenneth E. Schmader,Nick Barber,Carmel Hughes,Kate L. Lapane,Christian Swine,Joseph T. Hanlon +6 more
TL;DR: This work defines and categorise appropriate prescribing in elderly people, critically review the instruments that are available to measure it and discuss their predictive validity, and critically review recent randomised controlled intervention studies that assessed the effect of optimisation strategies on the appropriateness of prescribing.
Journal ArticleDOI
Potentially Inappropriate Medications in the Elderly: The PRISCUS List
TL;DR: The validity and practicability of the PRISCUS list remain to be demonstrated and should be used as a component of an overall concept for geriatric pharmacotherapy in which polypharmacy and interacting medications are avoided, and doses are regularly re-evaluated.
Journal ArticleDOI
Potentially inappropriate medication use among elderly home care patients in Europe
Daniela Fialová,Eva Topinkova,Giovanni Gambassi,Harriet Finne-Soveri,Palmi V. Jonsson,Iain Carpenter,Marianne Schroll,Graziano Onder,Liv Wergeland Sørbye,Cordula Wagner,Jindra Reissigová,Roberto Bernabei +11 more
TL;DR: Substantial differences in potentially inappropriate medication use exist between European countries and might be a consequence of different regulatory measures, clinical practices, or inequalities in socioeconomic background.
Journal ArticleDOI
Interventions to improve the appropriate use of polypharmacy for older people
Susan Patterson,Cathal A. Cadogan,Ngaire Kerse,Christopher Cardwell,Marie C. Bradley,Cristín Ryan,Carmel Hughes +6 more
TL;DR: It is unclear whether interventions to improve appropriate polypharmacy, such as pharmaceutical care, resulted in clinically significant improvement; however, they appear beneficial in terms of reducing inappropriate prescribing.
References
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Basic and Clinical Pharmacology
TL;DR: Basic and clinical pharmacology , Basic and clinical Pharmacology , کتابخانه دیجیتال جندی شاپور اهواز
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Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine.
Mark H. Beers,Joseph G. Ouslander,Irving Rollingher,David B. Reuben,Jacqueline Brooks,John C. Beck +5 more
TL;DR: 30 factors agreed on by this method identify inappropriate use of such commonly used categories of medications as sedative-hypnotics, antidepressants, antipsychotics, antihypertensives, nonsteroidal anti-inflammatory agents, oral hypoglycemics, dementia treatments, platelet inhibitors, histamine2 blockers, antibiotics, decongestants, iron supplements, muscle relaxants, gastrointestinal antispasmodics, and antiemetics.