Potentially inappropriate prescribing in elderly: assessing doctor knowledge, confidence and barriers

Abstract

Many primary care doctors possess a poor knowledge of PIP and are unaware of prescribing guidelines such as the Beers criteria. Our survey indicates that doctor usage of the Beers criteria might correlate with improved judgement in prescribing for the elderly. Most doctors report multiple barriers to appropriate prescribing in the elderly. Lack of formal education about prescribing guidelines was the only barrier that correlated with the doctors' level of training.

High Prevalence of Inappropriate Benzodiazepine and Sedative Hypnotic Prescriptions among Hospitalized Older Adults

“…A survey of physicians found that residents were more likely than attending physicians to list lack of formal education as a barrier to appropriate prescribing. 24 Similarities are seen in a study of antibiotic appropriateness, where residents demonstrated gaps in knowledge of treatment of asymptomatic bacteriuria that seemed to vary by specialty. 25 Interestingly, we found that patients admitted to general internal medicine were prescribed fewer PIPs.…”

Evaluating pharmacotherapy education: urgent need for hard outcomes

“…Correlations between self-reported confidence and assessed basic or applied knowledge were absent or weak, with Pearson's correlations ranging from r = 0.07 to r = 0.25 (P < 0.05). This mismatch between confidence scores and knowledge scores has also been reported for residents [10].A commonly used approach to bridge the gap between knowledge/skills assessments and clinical practice is simulation-based education (Kirkpatrick level 3). While simulation has been shown to improve important learning outcomes, its contribution to clinical outcomes remains unclear [6].…”

Retrospective Study to Describe and Compare the Application of Select Sections of the STOPP/START and Beers Criteria in Medication Reviews in a Musculoskeletal Specialty Practice

“…The Beers Criteria has been studied extensively in the U.S. and the STOPP/START Criteria has been studied in a variety of settings across Europe; but minimally in the U.S. (Cahir et al, 2010;O'Mahony, Gallagher, Byrne, Hamilton, Barry, O'Connor, Kennedy, 2010;Vishwas, Harugeri, Parthasarathi, Ramesh, 2012;Ryan, O'Mahony, Kennedy, Weedle, Byrne, 2009;Pham & Dickman, 2007;Shahezwan et al, 2012;Ramaswamy et al, 2010;Fick & Semla, 2012;Resnick & Pacala, 2012;Gallagher et al 2008;Lang Hasso, Belmin, Payot, Baeyens, Vogt-Ferrier, Gallagher, O'Mahony, Michel, 2009, Cherubini et al, 2012Ubeda, Ferrandiz, Maicas, Gomez, Bonet, Peris, 2012, Windsant-van The previous studies were conducted in European settings. Few studies have examined the STOPP/START Criteria in the U.S., Brahmbhatt and colleagues (2013) applied the STOPP/START Criteria in the U.S. and found a significant decrease in the number of medications triggered as inappropriate after initial and follow-up application of the criteria.…”

“…and an expert consensus panel in 1991and updated in 1997(Cahir et al, 2010O'Mahony, Gallagher, Byrne, Hamilton, Barry, O'Connor, Kennedy, 2010;Vishwas, Harugeri, Parthasarathi, Ramesh, 2012;Ryan, O'Mahony, Kennedy, Weedle, Byrne, 2009;Pham & Dickman, 2007;Shahezwan et al, 2012;Ramaswamy et al, 2010;Fick & Semla, 2012;Resnick & Pacala, 2012;Cherubini, Corsonello, Lattanzio, 2012;Vieira de Lima, Garbin, Garbin, Sumida, Saliba, 2013;Gillespie, Alassaad, Hammarlund-Udenaes, Morlin, Henrohn, Bertilsson, Melhus, 2013). The American Geriatric Society recommends that the Beers Criteria will be updated every three years to remain current (Marcum & Hanlon, 2012;Campanelli, 2012).…”

“…Advanced age is associated with multiple normal aging changes. These changes coupled with increased numbers of chronic diseases, increased numbers of healthcare providers, and multiple medications increase the complexity of the plan of care (Opondo, Eslami ,Visscher, Rooij, Verheij, Korevaar, Abu-Hanna, 2012;Cahir, Fahey, Teeling, Teljeur, Feely, Bennett, 2010;Ramaswamy, Maio, Diamon, Talati, Hartmann, Arenson, Roehl, 2010).…”