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J Korean Med Assoc > Volume 52(1); 2009 > Article
Hong and Oh: Inappropriate Prescribing in the Elderly Patients

Abstract

In older people, medicines are considered appropriate when they have an evidence-based indication, are well-tolerated and cost-effective. However, inappropriate prescribing (IP) is a common and significant healthcare problem in elderly people in Korea as well as in the world. IP in old people is highly prevalent but preventable. Screening for IP is highly desirable, since detection and correction are simple and worthwhile. Until now, Beers' criteria for IP dominate the international literatures, although they have some defects. The 2002 version of Beers' criteria-independent of diagnosis includes 48 different categories of either single medications or multiple medications of a similar class identified as IP, and the 2002 version of Beers' criteria-considering diagnosis contains 19 different categories containing possible drug-disease interaction. Successful approaches to optimizing prescribing have been either educational or administrative. More research specially focused on the IP in the elderly is needed.

References

1. Chung H, Suh YW, Chon SJ, Lee ES, Lee BK, Kim KI. Analysis of inappropriate medication use in hospitalized geriatric patients. J Korean Soc Health-Syst Pham 2007;24:115-123.

2. Oh JM. Drug use pattern and evaluation for appropriateness in geriatric patients. Research report of Korea Food & Drug Administration 2004;04142:858-852.

3. Gallagher P, Barry P, O'Mahony D. Inappropriate prescribing in the elderly. J Clin Pharm Ther 2007;32:113-121.

4. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med 2003;163:2716-2724.

5. Garcia RM. Five ways you can reduce inappropriate prescribing in the elderly: a systematic review. J Fam Pract 2006;55:305-312.

Table 1
2002 Beers' criteria for potentially inappropriate medication use in older adults: independent of diagnoses or conditions
jkma-52-91-i001-l.jpg
Table 2
2002 Beers' briteria for potentially inappropriate medication use in older adults: considering diagnoses or conditions
jkma-52-91-i002-l.jpg

CNS: central nervous systems, COPD: chronic obstructive pulmonary disease, INR: international normalized ratio, MAOIs: monoamine oxidase inhibitors, NSAIDs: nonsteroidal anti-inflammatory drugs, SIADH: syndrome of inappropriate antidiuretic hormone secretion, SSRIs: selective serotonin reuptake inhibitors.



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