Identifying potentially inappropriate prescribing in older people with dementia: a systematic review
Open accessAbstract
PURPOSE: Older people with dementia are at risk of adverse events associated with potentially inappropriate prescribing. AIM: to describe (1) how international tools designed to identify potentially inappropriate prescribing have been used in studies of older people with dementia, (2) the prevalence of potentially inappropriate prescribing in this cohort and (3) advantages/disadvantages of tools METHODS: Systematic literature review, designed and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). MEDLINE, EMBASE, PsychInfo, CINAHL, the Cochrane Library, the Social Science Citation Index, OpenGrey, Base, GreyLit, Mednar and the National Database of Ageing Research were searched in April 2016 for studies describing the use of a tool or criteria to identify potentially inappropriate prescribing in older people with dementia. RESULTS: Three thousand three hundred twenty-six unique papers were identified; 26 were included in the review. Eight studies used more than one tool to identify potentially inappropriate prescribing. There were variations in how the tools were applied. The Beers criteria were the most commonly used tool. Thirteen of the 15 studies using the Beers criteria did not use the full tool. The prevalence of potentially inappropriate prescribing ranged from 14 to 74% in older people with dementia. Benzodiazepines, hypnotics and anticholinergics were the most common potentially inappropriately prescribed medications. CONCLUSIONS: Variations in tool application may at least in part explain variations in potentially inappropriate prescribing across studies. Recommendations include a more standardised tool usage and ensuring the tools are comprehensive enough to identify all potentially inappropriate medications and are kept up to date.
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Anticholinergics and sedatives are commonly used inappropriate medications in older patients with dementia.
“Anticholinergics and sedatives are commonly used inappropriate medications.”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [22]
Polypharmacy in older patients with dementia is usual, with a prevalence of 25%-98%.
“Polypharmacy in older patients with dementia is usual (with a prevalence of 25%-98%).22”
From Current and Future Treatments in Alzheimer Disease: An Update (2020) · cites this paper as [22]
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- Authors
- Hukins, D., Macleod, U., & Boland, J. W.
- Affiliations
- University of Hull (GB)
- Corresponding author
- Boland, Jason W.
- Venue
- European Journal of Clinical Pharmacology
- Published
- 2019-01-04
- Volume
- 75
- Issue
- 4
- Pages
- 467-481
- ISSN
- 0031-6970 (ISSN-L)
- 1432-1041
- OpenAlex
- W2908039570
- Cited by
- 84
- References
- 80
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 12 · 2023: 16 · 2022: 15 · 2021: 16 · 2020: 10 · 2019: 6
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- European Journal of Clinical Pharmacology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repository@Hull (Worktribe) (University of Hull) (acceptedVersion, cc-by)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion, cc-by)
- Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
- Funders
- University of Hull
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- potentially inappropriate prescribing, dementia, older adults, Beers criteria, screening tool, prevalence, benzodiazepines, hypnotics, anticholinergic agents, adverse drug reactions
- MeSH terms
- Potentially Inappropriate Medication List, Aged, Aged, 80 and over, Benzodiazepines, Dementia, Female, Humans, Hypnotics and Sedatives, Male, Drug Prescriptions, Randomized Controlled Trials as Topic, Cholinergic Antagonists, Polypharmacy, Inappropriate Prescribing
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