A team of researchers from RMIT University and Monash University has created a list of 16 potentially inappropriate medications for older people and their safer alternatives.
A team of researchers from RMIT University and Monash University has created a list of 16 potentially inappropriate medications for older people and their safer alternatives. The list, which is the first of its kind in Australia, aims to help health professionals improve medication management and safety for older people, who are more likely to experience adverse effects, drug interactions, and increased risk of falls and death from certain medications.
The list was developed by a multidisciplinary panel of 33 experts, who reviewed 130 medications or medication classes based on the latest evidence and clinical guidelines. The panel considered the benefits and harms of each medication, as well as the availability and suitability of alternative options. The list includes common medications such as ibuprofen, lorazepam, and codeine, some of which can be replaced by paracetamol, melatonin, and tramadol, respectively.
The researchers said that the list was not intended to prohibit the use of the potentially inappropriate medications, but rather to encourage health professionals to carefully assess the need and appropriateness of each medication for each individual patient. They also said that the list was not exhaustive, and that other medications may also pose risks for older people. They recommended that health professionals regularly review the medications of older people, and involve them and their carers in the decision-making process.
Potentially inappropriate medications are a major cause of medication-related harm and hospitalisation among older people in Australia and worldwide
Potentially inappropriate medications are a major cause of medication-related harm and hospitalisation among older people in Australia and worldwide. According to the researchers, around 20–70% of older people are prescribed at least one potentially inappropriate medication, and medication-related adverse effects contribute to 20% of all unplanned hospital admissions, with half of them being potentially preventable.
The researchers said that the use of potentially inappropriate medications in older people was influenced by various factors, such as the lack of an updated and relevant list for the Australian context, the differences in medication availability and prescribing patterns across countries, the complexity and variability of clinical situations and patient preferences, and the limited access to medication review services and resources.
The researchers said that their list was designed to address some of these gaps and challenges, and to provide a useful and practical tool for health professionals in Australia. They said that their list was unique in that it also suggested safer alternatives for some of the potentially inappropriate medications, which could facilitate the deprescribing process and the transition to more suitable treatments.
The list of potentially inappropriate medications and their safer alternatives is published in the journal BMJ Open and is available online for free
The list of potentially inappropriate medications and their safer alternatives is published in the journal BMJ Open and is available online for free. The researchers said that they planned to update the list regularly, and to evaluate its impact and implementation in clinical practice. They also said that they hoped that their list would raise awareness and stimulate discussion among health professionals, researchers, policymakers, consumers, and family members about the risks and benefits of medications for older people.
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