McLeod et al identified inappropriate prescription practices for older adults in Canada. Certain principles can help guide the clinician when selecting the best drug for the patient. The authors are from McGill University in Montreal.
Patient selection: older adult with age range not specified
Prescription of a drug for an older adult is classified as inappropriate if one or more of the following are present:
(1) there is an unacceptable risk to benefit ratio (more harm than good)
(2) the drug can cause significant drug-drug interactions
(3) the drug can cause significant drug-disease interactions
Additional reasons to consider a prescribing practice as inappropriate:
(1) The medication is associated with a significant risk of a serious adverse effect.
(2) An alternative drug is available with (a) the same or greater effectiveness and (b) less risk.
(3) The practice is encountered with enough frequency to justify a warning.
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