51. Potentially inappropriate medications in the elderly: a comprehensive protocol
- Author
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Vera Vlahović-Palčevski and Suzana Mimica Matanović
- Subjects
Drug ,Drug–drug interactions ,medicine.medical_specialty ,media_common.quotation_subject ,Beers Criteria ,MEDLINE ,potentially inappropriate medications . elderly patients . PIM screening tools . drug-prescribing behavior . drug–drug interactions ,Inappropriate Prescribing ,BIOMEDICINE AND HEALTHCARE. Basic Medical Sciences. Pharmacology ,Pharmacology ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Klinička farmakologija s toksikologijom ,medicine ,Humans ,Medication Errors ,Pharmacology (medical) ,Drug Interactions ,Intensive care medicine ,Geriatric Assessment ,media_common ,Aged ,Protocol (science) ,PIM screening tools ,business.industry ,Potentially Inappropriate Medications ,Age Factors ,BIOMEDICINA I ZDRAVSTVO. Temeljne medicinske znanosti. Farmakologija ,General Medicine ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Clinical Pharmacology and Toxicology ,Elderly patients ,Increased risk ,Underlying disease ,Relative risk ,Drug-prescribing behavior ,business ,Potentially inappropriate medications - Abstract
Elderly patients are at increased risk of drug-related morbidity and mortality. Avoiding the use of potentially inappropriate medications (PIMs) is one of the strategies that has been widely adopted to reduce the harmful consequences of drug use. There are several PIM screening tools available. In this review, we provide an overview of existing screening tools to detect PIMs in the elderly, emphasizing the advantages and disadvantages of each. Combining previously published and adopted tools (adjusted Beers list, French consensus panel, McLeod’s list, and Lindblad’s list of clinically important drug–disease interactions), we develop a new comprehensive tool that also includes the adjusted Hanlon’s and Malone’s lists of potentially serious drug–drug interactions in the elderly. In addition to listed PIMs and clinically important drug–drug interactions, alternative therapeutic solutions are suggested. The new protocol differentiates: drugs with an unfavorable benefit/risk ratio (to be avoided regardless of the underlying disease/condition), drugs with a questionable efficacy, and drugs to be avoided with certain diseases/conditions, and provides a list of potentially serious drug–drug interactions. A tool consisting of PIMs and potential drug–drug interactions within the same protocol provides more comprehensive quality assessment of drug-prescribing behavior to the elderly, which in turn may lead to better prescribing practices.
- Published
- 2011
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