Medication errors in older adults: a review of recent publications.
OBJECTIVE
This paper reviews recent articles examining medication errors in the elderly.


METHODS
MEDLINE and International Pharmaceutical Abstracts were searched for articles published in 2006 using a combination of the terms medication errors, medication adherence, medication compliance, suboptimal prescribing, and aged. A manual search of the reference lists of the identified articles and the authors' article files, book chapters, and recent reviews was conducted to identify additional publications. Those studies that described new measures of medication errors or had a randomized controlled design, evaluated the impact of an intervention on > or =1 measure of medication errors, and involved the community-dwelling elderly were included in the review.


RESULTS
The search identified 5 studies and a new set of explicit criteria for prescribing problems in nursing homes from the Centers for Medicare and Medicaid Services (CMS). One of the studies found a new instrument, the Medication Management Instrument for Deficiencies in the Elderly, to be a reliable and valid measure of medication management in older adults. A study in the ambulatory elderly found that 13.0% reported cost-related medication nonadherence. A randomized controlled trial of a pharmacist intervention in elderly patients at high risk for coronary events found the intervention was associated with improvements in both medication adherence and systolic blood pressure control. The report from the CMS described new explicit criteria for unnecessary drug use in elderly patients in long-term care facilities, including drugs to avoid, drugs that should be limited in dose or duration, drugs to be monitored, and drug-drug interactions. A modified Delphi survey of an expert panel reached consensus on 28 drug-disease interactions in older adults. Finally, a randomized controlled trial of computerized feedback in a health maintenance organization found improvements in inappropriate prescribing of target drugs in older adults.


CONCLUSIONS
Data from recently published studies may provide guidance to practitioners and help direct future research.
Aspinall
Sherrie
S
Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Sevick
Mary Ann
MA
Donohue
Julie
J
Maher
Robert
R
Hanlon
Joseph T
JT
D000367:Age Factors; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008134:Long-Term Care; D008508:Medication Errors; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012307:Risk Factors