Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Drugs & Aging
Erschienen in: Drugs & Aging 9/2008

01.09.2008 | Original Research Article

Inappropriate Medication Use and Prescribing Indicators in Elderly Australians

Development of a Prescribing Indicators Tool

verfasst von: Benjamin J. Basger, Timothy F. Chen, Rebekah J. Moles

Erschienen in: Drugs & Aging | Ausgabe 9/2008

Einloggen, um Zugang zu erhalten

Abstract

Background: Evidence-practice gaps, adverse medication-related incidents and unplanned medical admissions to hospital are common in elderly Australians. Many prescribing indicator tools designed to address some of these problems have been reported in the literature, the most common of which is the Beers list of inappropriate medications in the elderly. However, many of these tools are not appropriate for the Australian healthcare environment without modification and validation, and there appears to be a need for a tool based on Australian data.
Objective: To develop a list of prescribing indicators for elderly (aged >65 years) Australians based on the most frequent medications prescribed to Australians, and the most frequent medical conditions for which elderly Australians consult medical practitioners.
Method: The most common reasons for elderly Australians to seek or receive healthcare were cross-referenced with the 50 highest-volume Pharmaceutical Benefits Scheme medications prescribed to Australians in 2006 to develop prescribing indicators in the elderly using Australian medication and medical condition information resources.
Results: Forty-eight prescribing indicators were identified, consisting mainly of optimum as well as inappropriate medication choices for a large number of common medical conditions in the elderly.
Conclusion: A prescribing indicators tool was developed. This tool is envisaged as forming an important part of the medication review process, which is aimed at addressing the common problem of adverse medication-related events in elderly Australians.
Literatur
1.
2.
3.
Roughead EE, Lexchin J. Adverse drug events: counting is not enough, action is needed. Med J Aust 2006; 184(7): 315–6PubMed
4.
Harris MF, Zwar NA. Care of patients with chronic disease: the challenge for general practice. Med J Aust 2007; 187: 104–7PubMed
5.
Miller GC, Britt HC, Valenti L. Adverse drug events in general practice patients in Australia. Med J Aust 2006; 184(7): 321–4PubMed
6.
Chan M, Nicklason F, Vial JH. Adverse drug events as a cause of hospital admission in the elderly. Int Med J 2001; 31(4): 199–205CrossRef
7.
Pirmohamed M, James S, Meakin S, et al. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329(7456): 15–9PubMedCrossRef
8.
Routledge PA, O’Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. Br J Clin Pharmacol 2004; 57(2): 121–6PubMedCrossRef
9.
Merle L, Laroche ML, Dantoine T, et al. Predicting and preventing adverse drug reactions in the very old. Drugs Aging 2005; 22(5): 375–92PubMedCrossRef
10.
Gallagher P, Barry P, O’Mahony D. Inappropriate prescribing in the elderly. J Clin Pharm Ther 2007; 32: 113–21PubMedCrossRef
11.
Elliott RA. Problems with medication use in the elderly: an Australian perspective. J Pharm Pract Res 2006; 36(1): 58–66
12.
Burgess CL, Holman CD, Satti AG. Adverse drug reactions in older Australians, 1981–2002. Med J Aust 2005; 182(6): 267–70PubMed
13.
Zhang M, Holman CD, Preen DB, et al. Repeat adverse drug reactions causing hospitalization in older Australians: a population-based longitudinal study 1980–2003. Br J Clin Pharmacol 2007; 63(2): 163–70PubMedCrossRef
14.
Buchan H. Turning knowledge into action. Australian Prescriber 2007; 30(5): 114–5
15.
Hanlon JT, Schmader KE, Samsa GP, et al. A method for assessing drug therapy appropriateness. J Clin Epidemiol 1992; 45(10): 1045–51PubMedCrossRef
16.
Lipton HL, Bero LA, Bird JA, et al. The impact of clinical pharmacists’ consultations on physicians’ geriatric drug prescribing: a randomized controlled trial. Med Care 1992; 30(7): 646–58PubMedCrossRef
17.
Lipton HL, Bird JA, Bero LA, et al. Assessing the appropriateness of physician prescribing for geriatric outpatients: development and testing of an instrument. J Pharm Technol 1993; 9(3): 107–13PubMed
18.
Tamblyn RM, McLeod PJ, Abrahamowicz M, et al. Questionable prescribing for elderly patients in Quebec. CMAJ 1994; 150(11): 1801–9PubMed
19.
Newton PF, Levinson W, Maslen D. The geriatric medication algorithm: a pilot study. J Gen Intern Med 1994; 9(3): 164–7PubMedCrossRef
20.
Oborne CA, Batty GM, Maskrey V, et al. Development of prescribing indicators for elderly medical inpatients. Br J Clin Pharmacol 1997; 43(1): 91–7PubMedCrossRef
21.
Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: an update. Arch Intern Med 1997; 157(14): 1531–6PubMedCrossRef
22.
McLeod PJ, Huang AR, Tamblyn RM, et al. Defining inappropriate practices in prescribing for elderly people: a national consensus panel. CMAJ 1997; 156(3): 385–91PubMed
23.
Parkes AJ, Coper LC. Inappropriate use of medications in the veteran community: how much do doctors and pharmacists contribute? Aust N Z J Public Health. 1997; 21(5): 469–76PubMedCrossRef
24.
Brown NJ, Griffin MR, Ray WA, et al. A model for improving medication use in home health care patients. J Am Pharm Assoc (Wash) 1998; 38(6): 696–702
25.
26.
Knight EL, Avorn J. Quality indicators for appropriate medication use in vulnerable elders. Ann Intern Med 2001; 135 (8 Pt 2): 703-10
27.
Zhan C, Sangl J, Bierman AS, et al. Potentially inappropriate medication use in the community-dwelling elderly: findings from the 1996 Medical Expenditure Panel Survey. JAMA 2001; 286(22): 2823–9PubMedCrossRef
28.
Mackinnon NJ, Hepler CD. Preventable drug-related morbidity in older adults: 1. Indicator development. J Manag Care Pharm 2002; 8(5): 365–71PubMed
29.
Robertson HA, MacKinnon NJ. Development of a list of consensus-approved clinical indicators of preventable drug-related morbidity in older adults. Clin Ther 2002; 24(10): 1595–613PubMedCrossRef
30.
Morris CJ, Cantrill JA, Hepler CD, et al. Preventing drug-related morbidity: determining valid indicators. Int J Qual Health Care 2002; 14(3): 183–98PubMedCrossRef
31.
Morris CJ, Cantrill J. Preventing drug-related morbidity: the development of quality indicators. J Clin Pharm Ther 2003; 28(4): 295–305PubMedCrossRef
32.
Hajjar ER, Hanlon JT, Artz MB, et al. Adverse drug reaction risk factors in older outpatients. Am J Geriatr Pharmacotherapy 2003; 1(2): 82–9CrossRef
33.
34.
35.
Fick DM, Cooper JW, Wade WE, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Int Med 2003; 163(22): 2716–24CrossRef
36.
Byles JE, Heinze R, Nair BK, et al. Medication use among older Australian veterans and war widows. Int Med J 2003; 33(8): 388–92CrossRef
37.
Higashi T, Shekelle PG, Solomon DH, et al. The quality of pharmacologic care for vulnerable older patients. Ann Intern Med 2004; 140(9): 714–20PubMed
38.
Tully MP, Cantrill JA. The validity of explicit indicators of prescribing appropriateness. Int J Qual Health Care 2006; 18(2): 87–94PubMedCrossRef
39.
Okechukwu I, Bennett K, Feely J. General practitioners’ ranking of evidence-based prescribing quality indicators: a comparative study with a prescription database. Br J Clin Pharmacol 2006; 62(2): 218–24PubMedCrossRef
40.
41.
Allenet B, Bedouch P, Rose FX, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci 2006; 28(4): 181–8PubMedCrossRef
42.
Laroche ML, Charmes JP, Merle L. Potentially inappropriate medications in the elderly: a French consensus panel list. Eur J Clin Pharmacol 2007; 63: 725–31PubMedCrossRef
43.
Naugler CT, Brymer C, Stolee P, et al. Development and validation of an improving prescribing in the elderly tool. Can J Clin Pharmacol 2000; 7(2): 103–7PubMed
44.
Elliott RA, Woodward MC, Oborne CA. Indicators of prescribing quality for elderly hospital inpatients. Aust J Hosp Pharm 2001; 31(1): 19–25
45.
Gallagher P, Ryan C, Byrne S, et al. STOPP (screening tool of older person’s prescriptions) and START (screening tool to alert doctors to right treatment): consensus validation. Int J Clin Pharmacol Ther 2008; 46(2): 72–83PubMed
46.
Beers MH, Ouslander JG, Rollingher I, et al. Explicit criteria for determining inappropriate medication use in nursing home residents: UCLA Division of Geriatric Medicine. Arch Intern Med 1991; 151(9): 1825–32PubMedCrossRef
47.
48.
Australian Institute of Health and Welfare. Australia’s health 2006: report no.: AIHW cat. no. AUS 73. Canberra (ACT): AIHW, 2006
49.
50.
Rossi S, editor. Australian medicines handbook 2008. Adelaide (SA): Australian Medicines Handbook Pty Ltd, 2008
51.
Australian medicines handbook drug choice companion: aged care. 2nd ed. Adelaide (SA): Australian Medicines Handbook Pty Ltd, 2006
52.
53.
eTG complete [CD-ROM]. Melbourne (VIC): Therapeutic Guidelines, 2006 Jan
54.
55.
56.
Mallet L, Spinewine A, Huang A. The challenge of managing drug interactions in elderly people. Lancet 2007; 370: 185–91PubMedCrossRef
57.
The Australian pharmaceutical formulary and handbook. 20th ed. Canberra (ACT): The Pharmaceutical Society of Australia, 2006
58.
59.
60.
61.
62.
63.
64.
Amabile CM, Spencer AP. Keeping your patients with heart failure safe: a review of potentially dangerous medications. Arch Intern Med 2004; 164: 709–20PubMedCrossRef
65.
66.
67.
68.
69.
70.
71.
72.
McGavock H. Prescription-related illness: a scandalous pandemic. J Eval Clin Pract 2004; 10(4): 491–7PubMedCrossRef
73.
Jano E, Aparasu RR. Healthcare outcomes associated with Beers’ criteria: a systematic review. Ann Pharmacother 2007; 41(3): 438–47PubMedCrossRef
74.
Hanlon JT, Schmader KE, Ruby CM, et al. Suboptimal prescribing in older inpatients and outpatients. J Am Geriatr Soc 2001; 49(2): 200–9PubMedCrossRef
75.
Spinewine A, Schmader KE, Barber N, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet 2007; 370: 173–84PubMedCrossRef
76.
Shelton PS, Fritsch MA, Scott MA. Assessing medication appropriateness in the elderly: a review of available measures. Drugs Aging 2000; 16(6): 437–50PubMedCrossRef
77.
78.
Stowasser DA, Allinson YM, O’Leary KM. Understanding the medicines management pathway. J Pharm Pract Res 2004; 34: 293–6
79.
80.
King MA, Roberts MS. The influence of the Pharmaceutical Benefits Scheme (PBS) on inappropriate prescribing in Australian nursing homes. Pharm World Sci 2007; 29: 39–42PubMedCrossRef
81.
Sloane PD, Zimmerman S, Brown LC, et al. Inappropriate medication prescribing in residential care/assisted living facilities. J Am Geriatr Soc 2002; 50(6): 1001–11PubMedCrossRef
82.
Gray SL, Hedrick SC, Rhinard EE, et al. Potentially inappropriate medication use in community residential care facilities. Ann Pharmacother 2003; 37(7–8): 988–93PubMedCrossRef
83.
Klarin I, Wimo A, Fastbom J. The association of inappropriate drug use with hospitalisation and mortality: a population-based study of the very old. Drugs Aging 2005; 22(1): 69–82PubMedCrossRef
84.
O’Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age Ageing 2008; 37: 138–41PubMedCrossRef
85.
Sorensen L, King MA, Peck R, et al. In-home medication reviews for war veterans: early experience in Australia. J Pharm Pract Res 2004; 34(2): 122–4
86.
Roughead EE, Anderson B, Gilbert AL. Potentially inappropriate prescribing among Australian veterans and war widows/widowers. Int Med J 2007; 37: 402–5CrossRef
87.
Elliott RA, Woodward MC, Oborne CA. Antithrombotic prescribing in atrial fibrillation: application of a prescribing indicator and multidisciplinary feedback to improve prescribing. Age Ageing 2002; 31: 391–6PubMedCrossRef
88.
Elliott RA, Woodward MC, Oborne CA. Quality of prescribing for elderly inpatients at nine hospitals in Victoria, Australia. J Pharm Pract Res 2003; 33(2): 101–5
89.
90.
Thompson PD, Clarkson P, Karas RH. Statin-associated myopathy. JAMA 2003; 289: 657–9
91.
Hilmer SN. The dilemma of polypharmacy. Australian Prescriber 2008; 31(1): 2–3
92.
Barry PJ, Gallagher P, Ryan C, et al. START (screening tool to alert doctors to the right treatment): an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing 2007; 36: 632–8PubMedCrossRef
93.
94.
Guthrie B, Inkster M, Fahey T. Tackling therapeutic inertia: role of treatment data in quality indicators. BMJ 2007; 335(7619): 542–4PubMedCrossRef
95.
Swagerty D, Brickley R; American Medical Directors Association; American Society of Consultant Pharmacists. American Medical Directors Association and American Society of Consultant Pharmacists joint position statement on the Beers List of Potentially Inappropriate Medications in Older Adults. J Am Med Dir Assoc 2005; 6(1): 80–6PubMedCrossRef
96.
Chutka DS, Takahashi PY, Hoel RW. Inappropriate medications for elderly patients. Mayo Clinic Proc 2004; 79: 122–39CrossRef
Metadaten
Titel
Inappropriate Medication Use and Prescribing Indicators in Elderly Australians
Development of a Prescribing Indicators Tool
verfasst von
Benjamin J. Basger
Timothy F. Chen
Rebekah J. Moles
Publikationsdatum
01.09.2008
Verlag
Springer International Publishing
Erschienen in
Drugs & Aging / Ausgabe 9/2008
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI
https://doi.org/10.2165/00002512-200825090-00004

Weitere Artikel der Ausgabe 9/2008

Drugs & Aging 9/2008 Zur Ausgabe

Original Research Article

Association between Depressive Symptoms and Use of HMG-CoA Reductase Inhibitors (Statins), Corticosteroids and Histamine H2 Receptor Antagonists in Community-Dwelling Older Persons

Review Article

Pharmacological Management of Primary Open-Angle Glaucoma

Current Opinion

What Defines Abnormal Lung Function in Older Adults with Chronic Obstructive Pulmonary Disease?

Review Article

Transdermal Delivery of Treatment for Alzheimer’s Disease

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

25.04.2024 | Hypotonie | Nachrichten

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 | Hypertonie | Nachrichten

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 | Parkinson-Krankheit | Nachrichten

Viel Bewegung in der Parkinsonforschung

25.04.2024 | Nierenkarzinom | Nachrichten

Adjuvante Immuntherapie verlängert Leben bei RCC
weitere anzeigen

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise