title: What types of inappropriate prescribing predict adverse drug reactions in older adults?
abstract: Adverse drug events happen all too often in older adults, but we still do not have a clear understanding of potentially modifiable risk factors, with the exception of polypharmacy. This paper critiques the article in this issue of The Annals entitled, "Inappropriate Prescribing Predicts Adverse Drug Events in Older Adults." A validated measure for self-reported adverse drug events was used, along with a modified measure for inappropriate prescribing that we developed nearly 2 decades ago (ie, Medication Appropriateness Index). Besides discussing the strengths and weaknesses of this article, we also recommend future research directions in this area.
authors.affiliation: Department of Medicine (Geriatrics), University of Pittsburgh, Pittsburgh, PA 15213, USA. jth14@pitt.edu
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hanlon
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Schmader
mesh_terms: D000367:Age Factors; D000368:Aged; D011307:Drug Prescriptions / Q000145:classification*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008508:Medication Errors / Q000145:classification / Q000639:trends; D004364:Pharmaceutical Preparations / Q000145:classification; D019338:Polypharmacy; D011237:Predictive Value of Tests
chemical_list: D004364:Pharmaceutical Preparations
references.citation: J Am Geriatr Soc. 1994 Dec;42(12):1241-7
references.pmid: 7983285
references.citation: Lancet. 2007 Jul 14;370(9582):173-184
references.pmid: 17630041
references.citation: Ann Pharmacother. 1997 May;31(5):529-33
references.pmid: 9161643
references.citation: Ann Pharmacother. 2010 Jun;44(6):957-63
references.pmid: 20460558
references.citation: J Am Geriatr Soc. 2009 Jun;57(6):1000-6
references.pmid: 19507293
references.citation: J Gerontol A Biol Sci Med Sci. 2006 May;61(5):511-5
references.pmid: 16720750
references.citation: J Clin Epidemiol. 1992 Oct;45(10):1045-51
references.pmid: 1474400
references.citation: Age Ageing. 2008 Nov;37(6):673-9
references.pmid: 18829684
references.citation: Am J Med. 2004 Mar 15;116(6):394-401
references.pmid: 15006588
references.citation: Ann Intern Med. 1992 Oct 15;117(8):634-40
references.pmid: 1530194
references.citation: J Clin Epidemiol. 1994 Aug;47(8):891-6
references.pmid: 7730892
references.citation: Ann Pharmacother. 1999 Nov;33(11):1147-53
references.pmid: 10573310
references.citation: Am J Med. 1996 Apr;100(4):428-37
references.pmid: 8610730
references.citation: Am J Health Syst Pharm. 2001 Sep 1;58(17):1622-6
references.pmid: 11556656
references.citation: J Am Geriatr Soc. 1997 Aug;45(8):945-8
references.pmid: 9256846