• Users Online: 542
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Contacts Login 
REVIEW
Year : 2018  |  Volume : 3  |  Issue : 1  |  Page : 22-26

Potentially Prescriptions Inappropriate (PPIs) in elderly patients in polytherapy: structured discussion on the effect of medication therapy review using evaluation criteria listed in literature on the administrative health care database


Hospital Pharmacy, Pharmaceutical Department, Tuscany North West Health Company, Area of Massa Carrara, Italy

Correspondence Address:
Lorella Magnani
Hospital Pharmacy, Pharmaceutical Department, Tuscany North West Health Company, Area of Massa Carrara
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2542-3975.228988

Rights and Permissions

In the last few years numerous evidences have shown an increased prevalence of “Potential Inappropriate Prescriptions (PPIs)” in the elderly (>/=65 years) and have estimated that more than 10% of all hospitalizations in this population are hospitalized for problems consequent to drugs given. The predictive factors more strongly related to the inappropriate use of drugs are polytherapy (>/= 5 drugs contemporary), uncritical application of guidelines in many cases inadequate and built with data from young subjects-adults affected by a single pathology, recommend drug regimens that do not consider the changes in the pharmacokinetics and pharmacodynamics parameters, exposing to significant risks. Considering that polytherapy is any case necessary (due to the effect of comorbidity and longer life expectancy), is unavoidable not acknowledge the impossibility, as much for clinicians as for any guideline all interactions: in this perspective the application of evaluation scientifically based criteria and information technology tools could represent a resource for to tend to prescriptive appropriateness, still a challenge for researchers, clinicians, manager, third-payers. The application of explicit criteria (ex. Beers and STOPP & START) to the administrative data base of pharmaceutical prescriptions could represent a screening too, not only to qualitatively and quantitatively asses PPIs, given immediate availability of information, but above all to create practical support for the clinician’s work by crating “adaptive database” for interactive research for specific conditions. However, regardless of more or less functional software applications, more multidimensional and multidisciplinary efforts (ex. geriatric counseling) are needed to take on problems related to polypharmacy in elderly patients: the most appropriate therapeutic regimen should combine guidelines, geriatric assessment, social and economic considerations, the patient’s will and should be periodically reviewed, especially as the presence of multiple comorbidities increases the risk of adverse reactions.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1791    
    Printed94    
    Emailed0    
    PDF Downloaded167    
    Comments [Add]    

Recommend this journal