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  1. The challenge of safer...
  2. The challenge of safer prescribing
Making A Difference Adverse Drug Reactions in Elderly People

The challenge of safer prescribing

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39520.686458.94 (Published 24 April 2008) Cite this as: BMJ 2008;336:956

This article has a correction. Please see:

  1. Anne Spinewine, clinical pharmacist and lecturer in pharmacotherapy anne.spinewine@uclouvain.be
  1. 1Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium

Doctors should pay greater attention to managing the risk-benefit relationship to improve care of patients over 65, urge Jerry Avorn and William Shrank (doi: 10.1136/bmj.39520.671053.94). The challenge of safer prescribing, says Anne Spinewine, lies in shared decision making

Quality improvement for the care of older people has become a priority in many countries. Elderly people consume a large proportion of health care, including drugs, and evidence shows that prescribing to this group is often inappropriate.1 Inappropriate prescribing occurs in all care settings and at the transition between settings. Negative consequences include adverse drug events, higher costs for the patient and society, and impaired quality of life.

Specific approaches tailored to the needs of frail elderly people are needed. A recent review of ways to optimise prescribing to older people found that geriatric medicine services (involving a multidisciplinary team that includes a geriatrician and other healthcare providers with specialised geriatrics training), involvement of pharmacists in care, and computerised decision support can all improve the quality of prescribing to this group in different settings.2 Quality improvement strategies are more likely …

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