Inappropriate prescribing in the hospitalized elderly patient: Defining the problem, evaluation tools, and possible solutions

Robert L Page II1, Sunny A Linnebur2, Lucinda L Bryant3, J Mark Ruscin41Associate Professor of Clinical Pharmacy and Physical Medicine, Clinical Specialist, Division of Cardiology and Heart Transplantation, 2Associate Professor of Clinical Pharmacy, Clinical Specialist, Center on the Aging, Schools of Pharmacy and Medicine, 3Assistant Professor of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA; 4Professor, Department of Pharmacy Practice, Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, IL, USAAbstract: Potentially inappropriate medication (PIM) prescribing in older adults is quite prevalent and is associated with an increased risk for adverse drug events, morbidity, and utilization of health care resources. In the acute care setting, PIM prescribing can be even more problematic due to multiple physicians and specialists who may be prescribing for a single patient as well as difficulty with medication reconciliation at transitions and limitations imposed by hospital formularies. This article highlights critical issues surrounding PIM prescribing in the acute care setting such as risk factors, screening tools, and potential strategies to minimize this significant public health problem.Keywords: inappropriate prescribing, aged, elderly, adverse drug events, adverse drug reactions, Beers’ criteria, screenin