Inappropriate prescribing and adverse drug events in older people

Hamilton, Hilary J.; Gallagher, Paul F.; O'Mahony, Denis

Inappropriate prescribing and adverse drug events in older people

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.date.updated	2017-04-10T10:30:17Z
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.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
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.doi	10.1186/1471-2318-9-5
dc.identifier.endpage	5-4	en
dc.identifier.issn	1471-2318
dc.identifier.issued	1	en
dc.identifier.journaltitle	BMC Geriatrics	en
dc.identifier.startpage	5-1	en
dc.identifier.uri	https://hdl.handle.net/10468/3866
dc.identifier.volume	9	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