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Inappropriate Prescribing in the Elderly Patients

Article information

J Korean Med Assoc. 2009;52(1):91-99
Publication date (electronic) : 2009 January 31
doi : https://doi.org/10.5124/jkma.2009.52.1.91
Chang Hyung Hong, MD1, Byoung Hoon Oh, MD2
1Department of Psychiatry, Ajou University School of Medicine, Korea. antiaging@ajou.ac.kr
2Department of Psychiatry, Yonsei University College of Medicine, Korea. drobh@chollian.net

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.

Keywords: Inappropriate prescribing; Drugs; Elderly; Beers' criteria

References

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3. Gallagher P, Barry P, O'Mahony D. Inappropriate prescribing in the elderly. J Clin Pharm Ther 2007. 32113–121.
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. 1632716–2724.
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Article information Continued

Copyright © 2009 Korean Medical Association

Table 1

2002 Beers' criteria for potentially inappropriate medication use in older adults: independent of diagnoses or conditions

Table 1

Table 2

2002 Beers' briteria for potentially inappropriate medication use in older adults: considering diagnoses or conditions

Table 2

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.