STOPP criteria PIMs, unlike Beers criteria PIMs, are significantly associated with avoidable ADEs in older people that cause or contribute to urgent hospitalization.

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Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a drug and an adverse clinical event is required. The Naranjo criteria are the most widely used tool for assessing ADE causality, however, they are often difficult to interpret in the context of older patients. ADE causality criteria that allow for the multiple co-morbidities and prescribed medications in older people are required. Ultimately, the current high prevalence of IP and ADEs is unacceptable. IP screening criteria need to be tested as an intervention to assess their impact on the incidence of ADEs in vulnerable older patients. There is a role for IP screening tools in everyday clinical practice. These should enhance, not replace good clinical judgement, which in turn should be based on sound pharmacogeriatric training.

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cytokeratins (CK) 14 and 18, and in XIAP, cIAP-1 and cIAP-2. Flow cytometry was used to assess viability and apoptosis, by propidium iodide DNA staining of the cells during differentiation. RESULTSMorphological changes and the increased CK-18 and decreased CK-14 expression confirmed differentiation of cells towards a secretory phenotype. Real-time PCR and Western blotting confirmed the expression of the IAPs in the HPr-1AR cells. There was a timedependent decrease in the mRNA expression of XIAP, cIAP-1 and cIAP-2 after treatment with DHT. Differentiation also resulted in decreased cIAP-1 and XIAP protein expression, but cIAP-2 remained unchanged. Spontaneous apoptosis was significantly increased during cellular differentiation. CONCLUSIONWe show for the first time that differentiation of HPr-1AR prostate epithelial cells results in the development of a transient end-stage cell that might be explained by the loss of the IAP family of proteins.