Inappropriate prescribing in the older population: need for new criteria.
Inappropriate prescribing (IP) is a common and serious global healthcare problem in elderly people, leading to increased risk of adverse drug reactions (ADRs), polypharmacy being the main risk factor for both IP and ADRs. IP in older people is highly prevalent but preventable; hence screening tools for IP have been devised, principally Beers' Criteria and the Inappropriate Prescribing in the Elderly Tool (IPET). Although Beers' Criteria have become the most widely cited IP criteria in the literature, nevertheless, they have serious deficiencies, including several drugs that are rarely prescribed nowadays, a lack of structure in the presentation of the criteria and omission of several important and common IP instances. New, more up-to-date, systems-based and easily applicable criteria are needed that can be applied in the routine clinical setting.
O'Mahony
Denis
D
Department of Geriatric Medicine, Cork University Hospital, Wilton Cork 4, Ireland. denis.omahony@mailp.hse.ie
Gallagher
Paul Francis
PF
D016907:Adverse Drug Reaction Reporting Systems / Q000458:organization & administration; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000187:drug effects* / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000592:standards / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D015994:Incidence; D007494:Ireland; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D020380:Needs Assessment; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment