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Appropriate prescribing in older people

Published online by Cambridge University Press:  01 May 2007

Indranil Mukhopadhyay
Affiliation:
City General Hospital, Stoke-on-Trent, Staffordshire, UK
Frank Lally
Affiliation:
Keele University Medical School, Stoke-on-Trent, Staffordshire, UK
Peter Crome*
Affiliation:
Keele University Medical School, Stoke-on-Trent, Staffordshire, UK
*
Address for correspondence: Professor P Crome, Keele University Medical School, Courtyard Annexe, City General Hospital, Newcastle Road, Stoke-on-Trent, Staffordshire ST4 6QG.

Extract

As people age they almost invariably develop diseases which lead to the prescription of drugs – both to prevent disease progression and for symptomatic relief. Unfortunately, drug treatment in later life is also problematic. There is a dearth of evidence on the efficacy of drugs in people over the age of 80, and members of this age group are at highest risk of adverse drug reactions (ADR).

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2008

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References

1Prescriptions Dispensed in the Community: Statistics for 1996 to 2006, England. Statistical Bulletin IC 2007 11C July 2007. Available from: URL: http://www.ic.nhs.uk/webfiles/publications/PrescDispensed%2096to06/Bulletin%20220807%20version%20for%202006.pdfGoogle Scholar
2Gurwitz, JH, Field, TS, Avorn, J et al. Incidence and preventability of adverse drug events in nursing homes. Am J Med 2000; 109: 8794.CrossRefGoogle ScholarPubMed
3Hanlon, JT, Schmader, KE, Ruby, CM, Weinberger, M. Suboptimal prescribing in older inpatients and outpatients. J Am Geriatr Soc 2001; 49: 200–09.CrossRefGoogle ScholarPubMed
4Crome, P, Pollock, K. Age-discrimination in prescribing: accounting for concordance. Rev Clin Gerontol 14; 14: 2005.CrossRefGoogle Scholar
5Department of Health. National Service Framework for Older People. Medicines and Older People. London: HMSO; 2001.Google Scholar
6Parish, PA. Drug prescribing–the concern of all. J Roy Soc sProm Health 1973; 93: 213–17.CrossRefGoogle ScholarPubMed
7Somel, M, Khaitovich, P, Bahn, S, Paabo, S, Lachmann, M. Gene-expression becomes heterogeneous with age. Curr Biol 2006; 16: R359R360.CrossRefGoogle ScholarPubMed
8Nelson, EA, Dannefer, D. Aged heterogeneity: fact or fiction? The fate of diversity in gerontological research. Gerontologist 1992; 32: 1723.CrossRefGoogle ScholarPubMed
9Jackson, SHD, Mangoni, AA, Batty, GM. Optimization of drug prescribing. Br J Clin Pharmacol 2004; 57: 231–36.CrossRefGoogle ScholarPubMed
10Barber, N. What constitutes good prescribing? BMJ 1995; 310 (6984): 923–5.CrossRefGoogle ScholarPubMed
11Nascher, IL. Geriatrics. NY Med J 1909; 358–59.Google Scholar
12Anantharaju, A, Feller, A, Chedid, A. The aging liver. Gerontology 2002; 48: 343–53.CrossRefGoogle ScholarPubMed
13Zeeh, J, Platt, D. The aging liver. Gerontology 2002; 48: 121–27.CrossRefGoogle ScholarPubMed
14Greenblatt, DJ, Harmatz, JS, Shapiro, L, Engelhardt, N, Gouthro, TA, Shader, RI. Sensitivity to triazolam in the elderly. N Engl J Med 1991; 324: 1691–98.CrossRefGoogle ScholarPubMed
15Castleden, CM, George, CF. The effect of ageing on the hepatic clearance of propranolol. Br J Clin Pharmacol 1979; 7: 4954.CrossRefGoogle ScholarPubMed
16Kaplan, C, Pasternack, B, Shah, H, Gallo, G. Age-related incidence of sclerotic glomeruli in human kidneys. Am J Pathol 1975; 80: 227–34.Google ScholarPubMed
17Muhlberg, W, Platt, D. Age-dependent changes of the kidneys: pharmacological implications. Gerontology 1999; 45: 243–53.CrossRefGoogle ScholarPubMed
18Leipzig, RM, Cumming, RG, Tinetti, ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999; 47: 3039.CrossRefGoogle ScholarPubMed
19Lewis, JH, Kilgore, ML, Goldman, DP et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol 2003; 21: 1383–89.CrossRefGoogle ScholarPubMed
20Hutchins, LF, Unger, JM, Crowley, JJ, Coltman, CA, Albain, KS. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med 1999; 341: 2061–67.CrossRefGoogle ScholarPubMed
21Rich, MW, Bosner, MS, Chung, MK, Shen, J, McKenzie, JP. Is age an independent predictor of early and late mortality in patients with acute myocardial infarction? Am J Med 1992; 92: 713.CrossRefGoogle ScholarPubMed
22Lee, PY, Alexander, KP, Hammill, BG, Pasquali, SK, Peterson, ED. Representation of elderly persons and women in published randomized trials of acute coronary syndromes. JAMA 2001; 286: 708–13.CrossRefGoogle ScholarPubMed
23Masoudi, FA, Havranek, EP, Wolfe, P et al. Most hospitalized older persons do not meet the enrollment criteria for clinical trials in heart failure. Am Heart J 2003; 146: 250–57.CrossRefGoogle Scholar
24Giovanazzi-Bannon, S, Rademaker, A, Lai, G, BensonAB, III AB, III. Treatment tolerance of elderly cancer patients entered on to phase II clinical trials: an Illinois Cancer Center study. J Clin Oncol 1994; 12: 2447–52.CrossRefGoogle Scholar
25Thiemann, DR, Coresh, J, Schulman, SP, Gerstenblith, G, Oetgen, WJ, Powe, NR. Lack of benefit for intravenous thrombolysis in patients with myocardial infarction who are older than 75 years. Circulation 2000; 101: 2239–46.CrossRefGoogle Scholar
26Royal Pharmaceutical Society of Great Britain. From Compliance to Concordance – Achieving Partnership in Medicine-taking. London: Royal Pharmaceutical Society of Great Britain; 1987.Google Scholar
27Royal College of Physicians. National Clinical Sentinel Audit of Evidence-based prescribing for Older People. London: Royal College of Physicians; 2000.Google Scholar
28Thomson, S, Crome, P. Appropriate prescribing in older people. Rev Clin Gerontol 2002; 12: 213–20.CrossRefGoogle Scholar
29Burns, E., Austin, CA., Bax, N D S. Elderly patients’ understanding of their drug therapy: The effect of cognitive function. Age Ageing 1990; 19: 236–40.CrossRefGoogle ScholarPubMed
30Beers, MH, Ouslander, JG, Fingold, SF et al. Inappropriate medication prescribing in skilled-nursing facilities. Ann Intern Med 1992; 117: 684–89.CrossRefGoogle ScholarPubMed
31Beers, MH, Ouslander, JG, Rollingher, I, Reuben, DB, Brooks, J, Beck, JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med 1991; 151: 1825–32.CrossRefGoogle ScholarPubMed
32Chin, MH, Wang, LC, Jin, L et al. Appropriateness of medication selection for older persons in an urban academic emergency department. Acad Emerg Med 1999; 6: 1232–41.CrossRefGoogle Scholar
33Lindley, CM, Tully, MP, Paramsothy, V, Tallis, RC. Inappropriate medication is a major cause of adverse drug reactions in elderly patients. Age Ageing 1992; 21: 294300.CrossRefGoogle Scholar
34Goulding, MR. Inappropriate medication prescribing for elderly ambulatory-care patients. Arch Intern Med 2004; 164: 305–12.CrossRefGoogle ScholarPubMed
35Stuck, AE, Beers, MH, Steiner, A, Aronow, HU, Rubenstein, LZ, Beck, JC. Inappropriate medication use in community-residing older persons. Arch Intern Med 1994; 154: 2195–200.CrossRefGoogle ScholarPubMed
36Zhan, C, Sangl, J, Bierman, AS et al. Potentially inappropriate medication use in the community-dwelling elderly: findings from the 1996 Medical Expenditure Panel Survey. JAMA 2001; 286: 2823–29.CrossRefGoogle ScholarPubMed
37Giron, MS, Wang, HX, Bernsten, C, Thorslund, M, Winblad, B, Fastbom, J. The appropriateness of drug use in an older non-demented and demented population. J Am Geriatr Soc 2001; 49: 277–83.CrossRefGoogle Scholar
38Montamat, SC, Cusack, B. Overcoming problems with polypharmacy and drug misuse in the elderly. Clin Geriatr Med 1992; 8: 143–58.CrossRefGoogle ScholarPubMed
39Kennerfalk, A, Ruigomez, A, Wallander, MA, Wilhelmsen, L, Johansson, S. Geriatric drug therapy and healthcare utilization in the United Kingdom. Ann Pharmacother 2002; 36: 797803.CrossRefGoogle ScholarPubMed
40Rollason, V, Vogt, N. Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Drugs Aging 2003; 20: 817–32.CrossRefGoogle ScholarPubMed
41Kaufman, DW, Kelly, JP, Rosenberg, L, Anderson, TE, Mitchell, AA. Recent patterns of medication use in the ambulatory adult population of the United States: The Slone Survey. JAMA 2002; 287: 337–44.CrossRefGoogle ScholarPubMed
42Naughton, C, Bennett, K, Feely, J. Prevalence of chronic disease in the elderly based on a national pharmacy claims database. Age Ageing 2006; 35: 633–36.CrossRefGoogle ScholarPubMed
43Rochon, PA, Gurwitz, JH. Optimising drug treatment for elderly people: the prescribing cascade. BMJ 1997; 315: 1096–69.CrossRefGoogle ScholarPubMed
44Harris, CM, Dajda, R. The scale of repeat prescribing. Br J Gen Pract 1996; 46: 649–53.Google ScholarPubMed
45Schwartz, RK, Soumerai, SB, Avorn, J. Physician motivations for non-scientific drug prescribing. Soc Sci Med 1989; 28: 577–82.CrossRefGoogle Scholar
46Zarba, A, Storr, CL, Wagner, FA. Carrying habits into old age: prescription drug use without medical advice by older American adults. J Am Geriatr Soc 2005; 53: 170–71.CrossRefGoogle ScholarPubMed
47Nolan, L, O'Malley, K. Prescribing for the elderly. Part I: Sensitivity of the elderly to adverse drug reactions. J Am Geriatr Soc 1988; 36: 142–49.CrossRefGoogle ScholarPubMed
48Hanlon, JT, Schmader, KE, Koronkowski, MJ et al. Adverse drug-events in high-risk older outpatients. J Am Geriatr Soc 1997; 45: 945–48.CrossRefGoogle ScholarPubMed
49Gallagher, P, Barry, P, O'Mahony, D. Inappropriate prescribing in the elderly. J Clin Pharm Therap 2007; 32: 113–21.CrossRefGoogle ScholarPubMed
50Rochon, PA, Gurwitz, JH. Prescribing for seniors: neither too much nor too little. JAMA 1999; 282: 113–15.CrossRefGoogle ScholarPubMed
51Grymonpre, RE, Mitenko, PA, Sitar, DS, Aoki, FY, Montgomery, PR. Drug-associated hospital admissions in older medical patients. J Am Geriatr Soc 1988; 36: 1092–98.CrossRefGoogle ScholarPubMed
52Wei, JY. Disorder of the heart. In: Hazzard, WR, Beirman, EL, Blass, JP eds. Principles of Geriatric Medicine and Gerontology, third edition. New York: McGraw-Hill; 1994. 517–32.Google Scholar
53Soumerai, SB, McLaughlin, TJ, Spiegelman, D, Hertzmark, E, Thibault, G, Goldman, L. Adverse outcomes of underuse of beta-blockers in elderly survivors of acute myocardial infarction. JAMA 1997; 277: 115–21.CrossRefGoogle ScholarPubMed
54Chin, MH, Wang, JC, Zhang, JX, Lang, RM. Utilization and dosing of angiotensin-converting enzyme inhibitors for heart failure. J Gen Intern Med 1997; 12: 563–66.CrossRefGoogle ScholarPubMed
55Croft, JB, Giles, WH, Roegner, RH, Anda, RF, Casper, ML, Livengood, JR. Pharmacologic management of heart failure among older adults by office-based physicians in the United States. J Fam Pract 1997; 44: 382–90.Google ScholarPubMed
56Mendelson, G, Aronow, WS. Underutilization of angiotensin-converting enzyme inhibitors in older patients with Q-wave anterior myocardial infarction in an academic hospital-based geriatrics practice. J Am Geriatr Soc 1998; 46: 751–52.CrossRefGoogle Scholar
57Rudd, AG, Lowe, D, Hoffman, A, Irwin, P, Pearson, M. Secondary prevention for stroke in the United Kingdom: results from the National Sentinel Audit of Stroke. Age Ageing 2004; 33: 280–86.CrossRefGoogle ScholarPubMed
58Mendelson, G, Aronow, WS. Underutilization of warfarin in older persons with chronic nonvalvular atrial fibrillation at high risk for developing stroke. J Am Geriatr Soc 1998; 46: 1423–34.CrossRefGoogle ScholarPubMed
59Unutzer, J, Ferrell, B, Llin, EHB, Marmon, T. Pharmacotherapy of pain in depressed older adults. J Am Geriatr Soc 2004; 52: 1916–22.CrossRefGoogle ScholarPubMed
60Strothers, HS, Rust, G, Minor, P, Fresh, E, Druss, B, Satcher, D. Disparities in antidepressant treatment in Medicaid elderly diagnosed with depression. J Am Geriatr Soc 2005; 53: 456–61.CrossRefGoogle ScholarPubMed
61Andrade, SE, Majumdar, SR, Chan, KA et al. Low frequency of treatment of osteoporosis among postmenopausal women following a fracture. Arch Intern Med 2003; 163: 2052–57.CrossRefGoogle ScholarPubMed
62Gurwitz, JH. Suboptimal medication use in the elderly. The tip of the iceberg. JAMA 1994; 272: 316–17.CrossRefGoogle ScholarPubMed
63Medication for Older People. Report of a working party of the Royal College of Physicians, second edition, 1997.Google Scholar
64Likierman, A. Performance indicators: 20 early lessons from managerial use. Pub Money Manage 1993; 13: 1522.CrossRefGoogle Scholar
65Beers, MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Arch Intern Med 1997; 157: 1531–36.CrossRefGoogle ScholarPubMed
66Fick, DM, Cooper, JW, Wade, WE, Waller, JL, Maclean, JR, Beers, MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Arch Intern Med 2003; 163: 2716–24.CrossRefGoogle ScholarPubMed
67Clopidogrel and modified-release dipyridamole in the prevention of occlusive vascular events. National Institute for Clinical Excellence 2004. Available from: URL: http://www.nice.org.uk/nicemedia/pdf/FAD_Clopdip_Vascular.pdfGoogle Scholar
68McLeod, PJ, Huang, AR, Tamblyn, RM, Gayton, DC. Defining inappropriate practices in prescribing for elderly people: a national consensus panel. CMAJ 1997; 156: 385–91.Google ScholarPubMed
69Naugler, CT, Brymer, C, Stolee, P, Arcese, ZA. Development and validation of an improving prescribing in the elderly tool. Can J Clin Pharmacol 2000; 7: 103–07.Google ScholarPubMed
70Fialova, D, Topinkova, E, Gambassi, G et al. Potentially inappropriate medication use among elderly home-care patients in Europe. JAMA 2005; 293: 1348–58.CrossRefGoogle ScholarPubMed
71Barry, PJ, O'Keefe, N, O'Connor, KA, O'Mahony, D. Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients. J Clil Pharm Therap 2006; 31: 617–26.CrossRefGoogle ScholarPubMed
72Hanlon, JT, Schmader, KE, Boult, C et al. Use of inappropriate prescription drugs by older people. J Am Geriatr Soc 2002; 50: 2634.CrossRefGoogle ScholarPubMed
73Wenger, NS, Shekelle, PG. Assessing care of vulnerable elders: ACOVE Project Overview. Ann Intern Med 2001; 135 (8 Part2): 642–46.CrossRefGoogle ScholarPubMed
74Knight, EL, Avorn, J. Quality indicators for appropriate medication use in vulnerable elders. Ann Intern Med 2001; 135 (Part 2): 703–10.CrossRefGoogle ScholarPubMed
75Hanlon, JT, Schmader, KE, Samsa, GP et al. A method for assessing drug therapy appropriateness. J Clin Epidemiol 1992; 45: 1045–51.CrossRefGoogle ScholarPubMed
76Cantrill, JA, Sibbald, B, Buetow, S. Indicators of the appropriateness of long-term prescribing in general practice in the United Kingdom: consensus development, face and content validity, feasibility, and reliability. Qual Saf Health Care 1998; 7: 130–35.CrossRefGoogle ScholarPubMed
77Buetow, SA, Sibbald, B, Cantrill, JA, Halliwell, S. Appropriateness in health care: Application to prescribing. Soc Sci Med 1997; 45: 261–71.CrossRefGoogle ScholarPubMed
78Oborne, CA, Batty, GM, Maskrey, V, Swift, CG, Jackson, SH. Development of prescribing indicators for elderly medical inpatients. Br J Clin Pharmacol 1997; 43: 9197.CrossRefGoogle ScholarPubMed
79Grant, RL, Batty, GM, Aggarwal, R et al. National sentinel clinical audit of evidence-based prescribing for older people: methodology and development. J Eval Clin Pract 2002; 8: 189–98.CrossRefGoogle ScholarPubMed
80Jefferey, S, Ruby, C, Twersky, J, Hanlon, JT. Effect of an interdisciplinary team on suboptimal prescribing in a long-term care facility. Consult Pharm 1999; 14: 1386–91.Google Scholar
81Barry, PJ, Gallagher, P, Ryan, C, O'Mahony, D. START (screening tool to alert doctors to the right treatment) an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing 2007; 36: 632–38.CrossRefGoogle Scholar
82Shrank, WH, Polinski, JM, Avorn, J. Quality indicators for medication-use in vulnerable elders. JAm Geriatr Soc 2007; 55: S373S382.Google ScholarPubMed
83Versi, E, Appell, R, Mobley, D, Patton, W, Saltzstein, D. Dry mouth with conventional and controlled-release oxybutynin in urinary incontinence. Obstet Gynecol 2000; 95: 718–21.Google ScholarPubMed
84Peterson, AM, Takiya, L, Finley, R. Meta-analysis of trials of interventions to improve medication adherence. Am J Health Syst Pharm 2003; 60: 657–65.CrossRefGoogle ScholarPubMed
85de Vries, T, Henning, R, Hogerzeil, H, Fresle, D. Guide to good prescribing. A practical manual. Geneva: World Health Organisation; 2000.Google Scholar
86Crotty, M, Halbert, J, Rowett, D et al. An outreach geriatric medication advisory service in residential aged care: a randomised controlled trial of case conferencing. Age Ageing 2004; 33: 612–17.CrossRefGoogle Scholar
87Wu, JYF, Leung, WYS, Chang, S et al. Effectiveness of telephone counselling by a pharmacist in reducing mortality in patients receiving polypharmacy: randomised controlled trial. BMJ 2006; 333 (7567): 522.CrossRefGoogle ScholarPubMed
88Monane, M, Matthias, DM, Nagle, BA, Kelly, MA. Improving prescribing patterns for the elderly through an online drug utilization review intervention: a system linking the physician, pharmacist, and computer. JAMA 1998; 280: 1249–52.CrossRefGoogle ScholarPubMed
89Teich, JM, Merchia, PR, Schmiz, JL, Kuperman, GJ, Spurr, CD, Bates, DW. Effects of computerized physician order entry on prescribing practices. Arch Intern Med 2000; 160: 2741–47.CrossRefGoogle ScholarPubMed
90Bates, DW, Leape, LL, Cullen, DJ et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998; 280: 1311–16.CrossRefGoogle Scholar
91Bates, DW. Using information technology to reduce rates of medication errors in hospitals. BMJ 2000; 320 (7237): 788–91.CrossRefGoogle ScholarPubMed