Intended for healthcare professionals


Tackling potentially inappropriate prescribing

BMJ 2018; 363 doi: (Published 14 November 2018) Cite this as: BMJ 2018;363:k4688

Linked research

Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission

  1. Anthony J Avery, professor of primary health care1,
  2. Jamie J Coleman, professor in clinical pharmacology and medical education2
  1. 1Division of Primary Care, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
  2. 2Institute of Clinical Sciences, College of Medical and Dental Sciences (CMDS), University of Birmingham, Edgbaston B15 2TT, UK
  1. Correspondence to: A J Avery tony.avery{at}

Opportunities to intervene are often missed

In 2017 the World Health Organization launched its third global patient safety challenge with the aim of reducing severe avoidable medication related harm by 50% over a five year period.1 Demonstrating such reductions may be difficult, but countries such as the UK are in a strong position to meet the spirit of this challenge with strong integration of healthcare systems and better use of electronic health records.

One important approach is to identify potentially inappropriate prescribing and correct it where necessary, with the expectation that this will avoid serious harm. Primary care in the UK is well placed to do this using electronic searches to identify patients at risk: effective interventions are available to reduce hazardous prescribing,2 and some evidence shows that this can also reduce associated hospital admissions.3 Secondary care is also increasingly enabled to tackle potentially inappropriate prescribing as electronic prescribing becomes more commonplace …

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