Journal ArticleDOI
Reliability of a Modified Medication Appropriateness Index in Ambulatory Older Persons
Lynn S Fitzgerald,Joseph T. Hanlon,Penny S. Shelton,Pamela B. Landsman,Kenneth E. Schmader,Charles C. Pulliam,Mark E. Williams +6 more
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TLDR
The modified MAI modified for elderly outpatients in a non-Veterans Affairs, ambulatory, elderly population and may provide pharmacists with a practical and standard method to evaluate patients' drug regimens and identify some potential drug-related problems.Abstract:
OBJECTIVE:To evaluate the reliability of a medication appropriateness index (MAI) modified for elderly outpatients in a non-Veterans Affairs setting.DESIGN:Reliability study.SETTING:General community.PARTICIPANTS:Ten community-dwelling elderly (> 65 y) taking five or more regularly scheduled medications and participating in a university-based health service intervention study.MAIN OUTCOME MEASURES:Interrater reliability of MAI ratings of 65 medications made by two clinical pharmacists for individual items and for an overall summed score was calculated by use of κ statistics and intraclass correlation coefficient.RESULTS:The interrater agreement for each of the individual MAI items was high for both appropriate and inappropriate ratings and ranged from 80% to 100% (overall κ = 0.64). Overall agreement for the summed score was good (intraclass correlation = 0.80).CONCLUSIONS:The modified MAI is a reliable instrument for evaluation of medication appropriateness in a non-Veterans Affairs, ambulatory, elderly ...read more
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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
Polypharmacy and prescribing quality in older people.
Michael A. Steinman,C. Seth Landefeld,Gary E. Rosenthal,Daniel Berthenthal,Saunak Sen,Peter J. Kaboli +5 more
TL;DR: To evaluate the relationship between inappropriate prescribing, medication underuse, and the total number of medications used by patients, a large number of patients with a history of depression and substance abuse are surveyed.
Journal ArticleDOI
Suboptimal Prescribing in Older Inpatients and Outpatients
Joseph T. Hanlon,Kenneth E. Schmader,Kenneth E. Schmader,Christine M. Ruby,Morris Weinberger +4 more
TL;DR: Evidence from well-controlled studies suggests that multidisciplinary teams and clinical pharmacy interventions can modify suboptimal drug use in older people.
Journal ArticleDOI
Inappropriate prescribing: criteria, detection and prevention.
TL;DR: The inappropriate prescribing detection tools or criteria most frequently cited in the literature are described and examined and their role in preventing inappropriate prescribing and other related healthcare outcomes are examined.
Journal ArticleDOI
The Quality of Pharmacologic Care for Vulnerable Older Patients
Takahiro Higashi,Paul G. Shekelle,David H. Solomon,Eric L. Knight,Carol P. Roth,John T. Chang,Caren Kamberg,Catherine H. MacLean,Roy T. Young,John S. Adams,David B. Reuben,Jerry Avorn,Neil S. Wenger +12 more
TL;DR: This study systematically evaluated medication management for a sample of older patients by taking advantage of a set of explicit process of care quality indicators developed and implemented in the Assessing Care of Vulnerable Elders (ACOVE) project.
References
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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.