Application of a prescribing indicators tool to assist in identifying drug-related problems in a cohort of older Australians

Int J Pharm Pract. 2012 Jun;20(3):172-82. doi: 10.1111/j.2042-7174.2011.00177.x. Epub 2011 Nov 8.

Abstract

Objective: Drug-related problems (DRPs) are common in older people, resulting in a disproportionate number of serious medication adverse events. Pharmacist-led interventions have been shown to be effective in identifying and reducing DRPs such as medication interactions, omission of recommended medications and use of ineffective medications. In 2008 we proposed a prescribing indicators tool to assist in identifying DRPs as part of the Australian medication review process. The objective was to apply the proposed prescribing indicators tool to a cohort of older Australians, to assess its use in detecting potential DRPs.

Methods: The prescribing indicators tool was applied in a cross-sectional observational study to 126 older (aged ≥65 years) English-speaking Australians taking five or more medications, as they were being discharged from a small private hospital into the community. Indicators were unmet when prescribing did not adhere to indicator tool guidelines.

Key findings: We found a high incidence of under-treatment, and use of inappropriate medications. There were on average 18 applicable indicators per patient, with each patient having on average seven unmet indicators.

Conclusion: The use of a prescribing indicators tool for commonly used medications and common medical conditions in older Australians may contribute to the efficient identification of DRPs.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Australia
  • Cohort Studies
  • Cross-Sectional Studies
  • Drug Interactions
  • Drug Utilization*
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Humans
  • Inappropriate Prescribing
  • Male