title: GPs, medications and older people: A qualitative study of general practitioners' approaches to potentially inappropriate medications in older people.
abstract: OBJECTIVE
  To explore the prescribing, and the rationale for this prescribing, of potentially inappropriate medications (PIMs) in older persons by Australian general practitioners (GPs).
  
  
  METHODS
  This was a qualitative study employing semistructured interviews and thematic analysis. GPs who had patients taking at least one PIM were invited to participate. PIMs were defined by the Beers criteria.
  
  
  RESULTS
  Twenty-two GPs from four regions in three Australian states participated. While none were aware of the Beers criteria, participant GPs displayed good knowledge of the potential adverse effects of these medications. They were comfortable with the continued prescription of the medications. This was based on often quite complex harm-benefit considerations of the biopsychosocial contexts of individual patients.
  
  
  CONCLUSIONS
  The concept of 'appropriate' versus 'inappropriate' medications implicit in classification systems such as the Beers criteria is at odds with complex considerations informing decision-making prescribing PIMs in older persons.
authors.affiliation: Discipline of General Practice, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Parker
authors.initials: P
authors.lastname: Magin
authors.affiliation: Discipline of General Practice, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Goode
authors.affiliation: Discipline of General Practice, University of Newcastle, Newcastle, New South Wales, Australia.
authors.forename: Dimity
authors.initials: D
authors.lastname: Pond
mesh_terms: D000367:Age Factors; D001291:Attitude of Health Personnel; D001315:Australia; D001364:Awareness; D002983:Clinical Competence; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D058005:General Practitioners; D005853:Geriatrics; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D018579:Patient Selection; D000067561:Potentially Inappropriate Medication List; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D018570:Risk Assessment; D012307:Risk Factors
keywords: decision-making; family practice; inappropriate prescribing; older people