Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Apr;8(2):132-8.
doi: 10.4321/s1886-36552010000200008. Epub 2010 Mar 15.

Comparison of prescribing criteria in hospitalised Australian elderly

Wararat Pattanaworasate  1 , Lynne Emmerton  2 , Lisa Pulver  2 , Karl Winckel  3
Affiliations

Comparison of prescribing criteria in hospitalised Australian elderly

Wararat Pattanaworasate et al. Pharm Pract (Granada). 2010 Apr.

Abstract

The Beers criteria (2003) and McLeod criteria (1997) have been applied internationally to quantify inappropriate prescribing in elderly populations. Similarly, guidelines have been published locally by the National Prescribing Service (NPS).

Objective: This study aimed to adapt, evaluate and compare the utility of these three established criteria in measuring prescribing appropriateness in a sample of hospitalised elderly patients.

Methods: Initial refinement of the criteria produced versions applicable to Australian practice. Inpatient records of 202 patients aged 65 years or older in six wards of the Princess Alexandra Hospital, Brisbane, Australia, were reviewed using the adapted criteria. 'Potentially inappropriate' prescribing was descriptively analysed using relevant denominators.

Results: The adapted criteria collectively listed 70 'potentially inappropriate' medicines or drug groups and 116 'potentially inappropriate' prescribing practices. Patients (mean age 80.0; SD=8.3 years) were prescribed, a median of eight medicines (SD=4.0). At least one 'potentially inappropriate' medicine was identified in 110 (55%) patients. 'Potentially inappropriate' prescribing practices averaged 1.1 per patient (range 1-6). The adapted Beers criteria identified more 'potentially inappropriate' medicines/practices (44%, 101/232) than the McLeod criteria (41%) and NPS criteria (16%). Aspirin, benzodiazepines, beta-blockers and dipyridamole were most commonly identified.

Conclusion: The Beers and McLeod criteria, developed internationally, required considerable modification for local prescribing. The three criteria differed in their focus and approaches, such that development and validation of national criteria, using the key features of these models, is recommended. There is potential to apply validated guidelines in clinical practice and review of prescribing, but only to supplement clinical judgement.

Keywords: Aged; Australia; Drug Utilization Review.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST

None declared.

References

    1. Canberra: Australian Bureau of Statistics; [Accessed 28 October 2009]. Australian Social Trends. Population projections. Available from < http://www.abs.gov.au/Ausstats/abs@.nsf/2f762f95845417aeca25706c00834efa... .
    1. Veterans’ MATES. Veteran's medicines advice and therapeutics education services. Therapeutic brief 8-reducing adverse drug events (ADEs) for your veteran patients. [Accessed 28 October 2009]; Available from < https://www.veteransmates.net.au/VeteransMATES/documents/module_material... .
    1. Laroche ML, Charmes JP, Bouthier F, Merle L. Inappropriate medications in the elderly. Clin Pharmacol Ther. 2009;85(1):94–97. - PubMed
    1. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med. 1991;151:1825–1832. - PubMed
    1. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the Beers criteria for potentially inappropriate medication use in older adults. Arch Intern Med. 2003;163:2716–2724. - PubMed

LinkOut - more resources