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Interventions that can reduce inappropriate prescribing in the elderly: a systematic review
Sukhpreet Kaur1, Geoffrey Mitchell, Luis Vitetta
1Therapeutics Research Unit, School of Medicine, University of Queensland, Woolloongabba, Queensland, Australia.
Drugs & Aging
|November 26, 2009
Summary
This review identifies strategies to reduce inappropriate prescribing in the elderly. Multidisciplinary case conferences involving geriatricians and computerized support systems show promise in improving medication practices.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Health Services Research
Background:
- Inappropriate prescribing in the elderly increases the risk of adverse drug events.
- Alternative therapies may offer better efficacy or safety profiles.
- Identifying effective interventions is crucial for optimizing geriatric pharmacotherapy.
Purpose of the Study:
- To systematically review interventions aimed at reducing inappropriate prescribing in the elderly population.
- To evaluate the effectiveness of various strategies, including educational programs, medication reviews, and technological support.
Main Methods:
- A systematic review of 24 original studies identified through electronic database searches.
- Studies included a wide range of participant numbers (56 to 124,802).
- Interventions assessed included educational programs, medication reviews, geriatrician services, multidisciplinary teams, computerized support systems, regulatory policies, and multi-faceted approaches.
Main Results:
- Computerized support systems significantly improved prescribing and dispensing practices.
- Multidisciplinary case conferences involving geriatricians were highly effective in reducing inappropriate prescribing.
- Educational interventions showed mixed results due to variability in study design and outcome assessment.
- Pharmacist interventions demonstrated variable effectiveness depending on the setting and criteria used.
Conclusions:
- Various strategies can reduce inappropriate prescribing in the elderly.
- Multidisciplinary approaches and computerized support systems appear particularly effective.
- Further research is needed to clarify the synergistic effects of combined interventions.
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