Inappropriate Drug Prescribing in Home-Dwelling, Elderly Patients

Pitkälä, Kaisu; Strandberg, Timo; Tilvis, Reijo S.

doi:10.1001/archinte.162.15.1707

Cited by 121 publications

(73 citation statements)

References 32 publications

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“…14 Other European workers 25,26 have identified that there may be country-specific factors, such as differences in clinical practice, that preclude the direct transfer of quality indicators from the U.S. to the U.K.. Indeed, our work supports their view.…”

Section: "They Reduce the Risk But Is Failure To Prescribe A Drug-resupporting

confidence: 64%

Preventable Drug-related Morbidity Indicators in the U.S. and U.K.

Morris

Ja²

2002

JMCP

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Section: "They Reduce the Risk But Is Failure To Prescribe A Drug-resupporting

confidence: 64%

Preventable Drug-related Morbidity Indicators in the U.S. and U.K.

Morris

Ja²

2002

JMCP

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“…A large number of general practices (n = 131) were involved in the study conducted in the UK, which reported a potential IP rate of 24.8% [14]. However, the rate of potential IP is less in other European centres (9.8% in Turkey and 12.5% in Finland) [9,11] compared with centres in the USA (21.3%, 23.5%, 28.8%). The reasons for the variation in IP rates are not clear from the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Beers' criteria were originally formulated in 1991 [7], updated in 1997 [8] and recently revised in 2003 [4]. Using Beers' criteria in primary care, IP rates of 9.8-38.5% have been reported in various European countries [9][10][11][12][13][14], while IP rates of 21.3-28.8% have been reported in the USA [15][16][17]. Beers' criteria have a number of serious deficiencies in relation to European prescribing patterns.…”

Section: Introductionmentioning

confidence: 99%

Potentially inappropriate prescribing in an Irish elderly population in primary care

Ryan¹,

O’Mahony

Kennedy³

et al. 2009

Brit J Clinical Pharma

249

251

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Potentially inappropriate prescribing in older people is a well‐documented problem and has been associated with adverse drug reactions and hospitalization.• Beers' criteria, Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) are screening tools that have been formulated to help physicians and pharmacists identify potentially inappropriate prescribing and potential prescribing omissions.• The prevalence of potentially inappropriate prescribing and prescribing omissions in the elderly population presenting to hospital with acute illness is high according to STOPP and START criteria. WHAT THIS STUDY ADDS • Potential errors of prescribing and of omission of medicines are prevalent among medically stable older people in primary care.• Screening tools should be incorporated into the everyday practice of primary care doctors and community pharmacists as a means of preventing potential errors of prescribing commission and prescribing omission in older people.AIMS Screening tools have been formulated to identify potentially inappropriate prescribing (IP) in older people. Beers' criteria are the most widely used but have disadvantages when used in Europe. New IP screening tools called Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) have been developed to identify potential IP and potential prescribing omissions (PPOs). The aim was to measure the prevalence rates of potential IP and PPOs in primary care using Beers' criteria, STOPP and START.METHODS Case records of 1329 patients ≥65 years old from three general practices in one region of southern Ireland were studied. The mean age ± SD of the patients was 74.9 ± 6.4 years, 60.9% were female. Patients' current diagnoses and prescription medicines were reviewed and the Beers' criteria, STOPP and START tools applied.RESULTS The total number of medicines prescribed was 6684; median number of medicines per patient was five (range 1–19). Overall, Beers' criteria identified 286 potentially inappropriate prescriptions in 18.3% (243) of patients, whilst the corresponding IP rate identified by STOPP was 21.4% (284), in respect of 346 potentially inappropriate prescriptions. A total of 333 PPOs were identified in 22.7% (302) of patients using the START tool.CONCLUSION Potentially inappropriate drug prescribing and errors of drug omission are highly prevalent among older people living in the community. Prevention strategies should involve primary care doctors and community pharmacists.

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“…[5][6][7] Since a significant number of medicationrelated problems are considered preventable, solutions to reduce them have been actively sought worldwide. [8][9][10][11][12][13] Various medication review procedures based on the philosophy of pharmaceutical care have been implemented in different countries.…”

Section: Introductionmentioning

confidence: 99%

Continuing Education Course to Attain Collaborative Comprehensive Medication Review Competencies

Leikola¹,

Tuomainen²,

Ovaskainen³

et al. 2009

Am J Pharm Educ

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Objective. To implement a long-term continuing education course for pharmacy practitioners to acquire competency in and accreditation for conducting collaborative comprehensive medication reviews (CMRs). Design. A 1½-year curriculum for practicing pharmacists that combined distance learning (using e-learning tools) and face-to-face learning was created. The training consisted of 5 modules: (1) Multidisciplinary Collaboration; (2) Clinical Pharmacy and Pharmacotherapy; (3) Rational Pharmacotherapy; (4) CMR Tools; and (5) Optional Studies. Assessment. The curriculum and participants' learning were evaluated using essays and learning diaries. At the end of the course, students submitted portfolios and completed an Internet-based survey instrument. Almost all respondents (92%) indicated their educational needs had been met by the course and 68% indicated they would conduct CMRs in their practice. The most important factors facilitating learning were working with peers and in small groups. Factors preventing learning were mostly related to time constraints. Conclusion. Comprehensive medication review competencies were established by a 1½-year continuing education curriculum that combined different teaching methods and experiential learning. Peer support was greatly appreciated as a facilitator of learning by course participants.

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Inappropriate Drug Prescribing in Home-Dwelling, Elderly Patients

Cited by 121 publications

References 32 publications

Preventable Drug-related Morbidity Indicators in the U.S. and U.K.

Preventable Drug-related Morbidity Indicators in the U.S. and U.K.

Potentially inappropriate prescribing in an Irish elderly population in primary care

Continuing Education Course to Attain Collaborative Comprehensive Medication Review Competencies

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