Inappropriate prescribing and adverse drug events in older people

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dc.contributor.author Hamilton, Hilary J.
dc.contributor.author Gallagher, Paul F.
dc.contributor.author O'Mahony, Denis
dc.date.accessioned 2017-04-10T10:35:23Z
dc.date.available 2017-04-10T10:35:23Z
dc.date.issued 2009-01-28
dc.identifier.citation Hamilton, H. J., Gallagher, P. F. and O'Mahony, D. (2009) 'Inappropriate prescribing and adverse drug events in older people', BMC Geriatrics, 9(1), pp. 5. doi:10.1186/1471-2318-9-5 en
dc.identifier.volume 9 en
dc.identifier.issued 1 en
dc.identifier.startpage 5-1 en
dc.identifier.endpage 5-4 en
dc.identifier.issn 1471-2318
dc.identifier.uri http://hdl.handle.net/10468/3866
dc.identifier.doi 10.1186/1471-2318-9-5
dc.description.abstract 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. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central en
dc.rights © 2009 Hamilton et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en
dc.rights.uri http://creativecommons.org/licenses/by/2.0/ en
dc.subject Aged en
dc.subject Drug Prescriptions en
dc.subject Drug Utilization en
dc.subject Humans en
dc.subject Medication Errors en
dc.subject Pharmaceutical Preparations en
dc.subject Inappropriate prescribing en
dc.subject Adverse drug events en
dc.title Inappropriate prescribing and adverse drug events in older people en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Denis O'Mahony, Medicine Department, University College Cork, Cork, Ireland. +353-21-490-3000 Email: denis.omahony@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2017-04-10T10:30:17Z
dc.description.version Published Version en
dc.internal.rssid 390672108
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Geriatrics en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress denis.omahony@ucc.ie en


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© 2009 Hamilton et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Except where otherwise noted, this item's license is described as © 2009 Hamilton et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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