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A systematic review of prescribing criteria to evaluate appropriateness of medications in frail older people

Published online by Cambridge University Press:  03 November 2014

A Poudel ,
NM Peel ,
C Mitchell ,
LM Nissen  and
RE Hubbard
A Poudel*
Affiliation:
School of Pharmacy, Queensland University of Technology, Brisbane, Queensland, Australia
NM Peel
Affiliation:
Centre for Research in Geriatric Medicine, Queensland University of Technology, Brisbane, Queensland, Australia
C Mitchell
Affiliation:
Centre for Safe and Effective Prescribing, The University of Queensland, Queensland University of Technology, Brisbane, Queensland, Australia
LM Nissen
Affiliation:
School of Pharmacy, Queensland University of Technology, Brisbane, Queensland, Australia Centre for Safe and Effective Prescribing, The University of Queensland, Queensland University of Technology, Brisbane, Queensland, Australia School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
RE Hubbard
Affiliation:
Centre for Research in Geriatric Medicine, Queensland University of Technology, Brisbane, Queensland, Australia
*
Address for correspondence: Arjun Poudel, School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia. Email: a.poudel@uq.edu.au
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Summary

This study systematically reviews the published literature regarding inappropriate prescribing in frail individuals aged at least 65 years. Twenty-five of 466 identified studies met the inclusion criteria. All papers measured some surrogate indicators of frailty, such as performance-based tests, cognitive function and functional dependency. Beers criteria were used in 20 studies (74%) to evaluate inappropriate medication use and 36% (9/25) studies used more than one criterion. The prevalence of inappropriate medications ranged widely from 11 to 92%. Only a few studies reported the relationship between potentially inappropriate medication use and surrogate measures of frailty. These diverse findings indicate the need for a standardized measure for assessing appropriateness of medication in frail older individuals. Prescribing tools should address both medication and patient-related factors such as life expectancy and functional status to minimize inappropriate prescribing in frail individuals.

Keywords

frailtyinappropriate prescribingolder peopleprescribing criteriaprevalence
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 24 , Issue 4 , November 2014 , pp. 304 - 318
Copyright
Copyright © Cambridge University Press 2014 

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