Instruments for evaluating medication use and prescribing in older adults

Area of Science:

• Geriatric Pharmacy
• Pharmacotherapy
• Medication Management

Background:

• Older adults often experience polypharmacy, increasing risks of adverse drug events.
• Assessing appropriate medication use in this population is complex.
• Implicit instruments offer a valuable approach to evaluating medication regimens.

Purpose of the Study:

• To describe and evaluate implicit instruments for assessing medication use in older adults.
• To identify tools suitable for pharmacy practice settings.
• To inform the selection of appropriate assessment instruments for geriatric patients.

Main Methods:

• A literature search was conducted using PubMed and Google Scholar.
• Included articles focused on implicit criteria for medication use in older adults.
• Seven instruments were reviewed based on characteristics, components, and validation settings.

Main Results:

• Seven implicit instruments were identified and evaluated.
• Tools vary in comprehensiveness, time intensity, and intended users (e.g., SMOG for community pharmacists, MAI, ARMOR, TIMER for comprehensive assessment).
• ACOVE-3 and GPGPA aid in medication continuation decisions for end-of-life care, while AOU guides initiation.

Conclusions:

• Each instrument has unique strengths and limitations for pharmacy practice.
• The optimal choice of instrument depends on the specific practice setting and clinical need.
• A combination of instruments may be necessary to achieve comprehensive medication optimization in older adults.