Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

Therapeutic Advances in Drug Safety
Denis CurtinDenis O'Mahony

Abstract

Polypharmacy and prescribing of potentially inappropriate medications (PIMs) are the key elements of inappropriate medication use (IMU) in older multimorbid people. IMU is associated with a range of negative healthcare consequences including adverse drug events and unplanned hospitalizations. Furthermore, prescribing guidelines are commonly derived from randomized controlled clinical trials which have specifically excluded older adults with multimorbidity. Consequently, indiscriminate application of single disease pharmacotherapy guidelines to older multimorbid patients can lead to increased risk of drug-drug interactions, drug-disease interactions and poor drug adherence. Both polypharmacy and PIMs are highly prevalent in older people and strategies to improve the quality and safety of prescribing, largely through avoidance of IMU, are needed. In the last 30 years, numerous explicit PIM criteria-based tools have been developed to assist physicians with medication management in clinically complex multimorbid older people. Very few of these PIM criteria sets have been tested as an intervention compared with standard pharmaceutical care in well-designed clinical trials. In this review, we describe the most widely used sets of exp...Continue Reading

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Citations

Sep 29, 2019·The International Journal of Risk & Safety in Medicine·Klejda HarasaniOrgesa Qipo
Jun 11, 2020·British Journal of Clinical Pharmacology·Marissa Anne SakirisDanijela Gnjidic
Sep 30, 2020·Journal of Palliative Medicine·Richard McNeillPaul Chin
Jun 27, 2019·Journal of Clinical Medicine·Valle Coronado-VázquezCarlos Ruiz-Frutos
Jan 9, 2021·European Geriatric Medicine·Arduino A Mangoni, Elzbieta A Jarmuzewska
Jan 28, 2021·International Journal of Environmental Research and Public Health·Kung-Chuan HsuTzu-Chueh Wang
Mar 23, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Thi Ngoc Mai NguyenBen Schöttker
Nov 23, 2020·Journal of the American Medical Directors Association·Carolina Tisnado GarlandCaroline Sirois

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Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

SENATOR
EURO
START
FORTA
NORGEP
PRISCUS
STOPP

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