Appropriate prescribing in older people

Mukhopadhyay, Indranil; Lally, Frank; Crome, Peter

doi:10.1017/s0959259808002396

Cited by 4 publications

(2 citation statements)

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“…PIM is defined as a medication that should be avoided in older adults due to their considerable risk of adverse reactions and the lack of clinical evidence behind their benefits when safer and more or equally effective therapeutic options are available [ 11 ]. PIM use occurs when the risk associated with the prescribed drugs outweighs potential benefits, especially when effective alternatives are available [ 12 ] whereas, ADEs are considered the fifth most common cause of mortality among hospitalised patients [ 13 , 14 ]. Several studies reported the cause of most ADEs as PIM, which are common in ambulatory care [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Knowledge, Attitude and Practices of the Hospital and Community Pharmacists in Saudi Arabia (Jeddah) towards Inappropriate Medication Use in Older Adults

Alfahmi

Curtain

Salahudeen

2023

IJERPH

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In Saudi Arabia, the older adult population is growing and is projected to increase three-fold by 2030. Potentially inappropriate medications (PIMs) are harmful to older adults’ and have a direct impact on clinical, health and economic outcomes. Pharmacists have a vital role in medication tailoring for older adults as multidisciplinary team members. However, there is also a paucity of research regarding pharmacists’ participation in detecting and avoiding PIMs use among older adults in Saudi Arabia. A cross-sectional, self-administered survey was conducted to assess the knowledge, practices, and attitude of pharmacists from seven hospitals and ten community pharmacies in Jeddah, Saudi Arabia. The survey comprised three sections; (i) identifying participants’ general characteristics, (ii) assessing their knowledge of PIMs use in older adults and (iii) examining the pharmacist’s attitude towards the procedures followed in dispensing for older adults. Inferential and descriptive statistics were used to analyse the survey data. A total of 157 community and hospital pharmacists participated in this study. Most of them dispensed medication weekly to older adults (85.4%), and 43.3% had relevant work experience of six to ten years. Though 44.6% of the participants were aware of PIMs that older adults should avoid, only 10.8% claimed adequate knowledge about PIMs. From the given three clinical case scenarios, a minority of pharmacists (21.7%) chose the correct answers, with a mean score of 2.38 ± 2.91 (95% CI 2.35–3.15). Participants who claimed to have knowledge of PIMs had a significantly higher mean score than those who did not, 4.59 ± 2.81 25 (95% CI 2.35–2.61). A minority of the pharmacists (14.7%) used screening tools such as STOPP, Beers criteria, or Medication Appropriateness Index (MAI) to detect PIMs in older adults. No statistically significant differences were detected when comparing the levels of knowledge of pharmacists with 1 to 5 years of practice to pharmacists with 6 to 15 and more years of experience (p = 0.431). Pharmacists’ knowledge, attitude and practices toward PIMs use in older adults in Saudi Arabia should be improved. The application of PIMs detection tools such as STOPP/START or Beers criteria currently has no place in day-to-day pharmacists’ roles in Saudi Arabia. Therefore, concerned stakeholders should develop educational programs to improve pharmacists’ knowledge of PIMs and promote the effective use of PIM screening tools such as Beers and STOPP criteria in their practice.

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Section: Introductionmentioning

confidence: 99%

Assessment of Knowledge, Attitude and Practices of the Hospital and Community Pharmacists in Saudi Arabia (Jeddah) towards Inappropriate Medication Use in Older Adults

Alfahmi

Curtain

Salahudeen

2023

IJERPH

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“…11 Since the original paper was written significant developments have occurred, in particular with regard to explicit prescribing criteria and use of information technology. These will be discussed below and the concept of appropriate prescribing in older people and the difficulties in achieving optimal prescribing practice will be explored.…”

Section: Introductionmentioning

confidence: 99%

Appropriate prescribing in older people

Penge

Crome

2013

Rev. Clin. Gerontol.

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Prescribing for older people is often complex and challenging. With age, people almost invariably develop diseases leading to the prescription of drugs and the risk of multiple prescribing increases, especially if there is strict adherence to single disease guidelines. There remains a paucity of evidence from clinical trials as to the efficacy of many drugs in patients aged over 80 years due to the gross under-representation of older people in clinical trials. Older people are also at increased risk of adverse drug events, which are an important cause of morbidity and mortality. A significant percentage of these are both predictable and potentially avoidable.In this updated review the concept of appropriate prescribing in older people is explored, including the importance of individualized care and shared decisionmaking. The available tools to enhance prescribing practice are examined, including those aimed at reducing inappropriate prescriptions and under prescribing. The limitations of existing tools are discussed and areas with particular promise and scope for advancement are highlighted, including the development of integrated IT systems and software engines to aid clinicians in appropriate prescribing.

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