Algorithm of medication review in frail older people: Focus on minimizing the use of high-risk medications

Geriatrics & Gerontology International
Arjun PoudelIan A Scott

Abstract

Frail older people typically suffer several chronic diseases, receive multiple medications and are more likely to be institutionalized in residential aged care facilities. In such patients, optimizing prescribing and avoiding use of high-risk medications might prevent adverse events. The present study aimed to develop a pragmatic, easily applied algorithm for medication review to help clinicians identify and discontinue potentially inappropriate high-risk medications. The literature was searched for robust evidence of the association of adverse effects related to potentially inappropriate medications in older patients to identify high-risk medications. Prior research into the cessation of potentially inappropriate medications in older patients in different settings was synthesized into a four-step algorithm for incorporation into clinical assessment protocols for patients, particularly those in residential aged care facilities. The algorithm comprises several steps leading to individualized prescribing recommendations: (i) identify a high-risk medication; (ii) ascertain the current indications for the medication and assess their validity; (iii) assess if the drug is providing ongoing symptomatic benefit; and (iv) consider withd...Continue Reading

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Citations

Mar 28, 2020·British Journal of Clinical Pharmacology·Matthias Michiels-CorstenAnnika Viniol
Aug 18, 2020·International Journal of Clinical Pharmacy·Heather E Barry, Carmel M Hughes
Nov 24, 2020·Archives of Gerontology and Geriatrics·Marcela ForgeriniPatrícia de Carvalho Mastroianni
Jun 12, 2021·European Journal of Clinical Pharmacology·Barbara RouxMarie-Laure Laroche
Apr 24, 2018·Journal of the American Medical Directors Association·Kaeshaelya ThiruchelvamSyed Shahzad Hasan
Jul 31, 2021·Research in Social & Administrative Pharmacy : RSAP·Kaeshaelya ThiruchelvamTherese Kairuz
Jul 10, 2021·British Journal of Clinical Pharmacology·Anne Kathrine BengaardMorten Baltzer Houlind

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