BACKGROUND Older adults take multiple medications and are at high risk for adverse drug effects. OBJECTIVE This systematic review was conducted to describe the impact of computer decision support (CDS) interventions designed to improve the quality of medication prescribing in older adults. METHODS PubMed and EMBASE databases were searched from January 1980 through July 2007 (English-languag...

OBJECTIVE To compare different indicators for assessing the quality of drug prescribing and establish their agreement in identifying doctors who may not adhere to treatment guidelines. DATA SOURCES/STUDY SETTING Data from 181 general practitioners (GPs) from The Netherlands. The case of asthma is used as an example because, in this area, different quality indicators exist whose validity is qu...

Judicious prescribing is a prerequisite for safe and appropriate medication use. Based on evidence and lessons from recent studies demonstrating problems with widely prescribed medications, we offer a series of principles as a prescription for more cautious and conservative prescribing. These principles urge clinicians to (1) think beyond drugs (consider nondrug therapy, treatable underlying ca...

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 me...

One in 20 prescriptions written by GPs in England contains an error, and one in 550 contains a serious error, a large study has found. The prevalence and causes of prescribing errors in general practice study, commissioned by the General Medical Council, shows that it is not doctors’ knowledge about drugs that is responsible for most errors but human factors and process issues. Errors chiefly o...

The rising rate of prescription opioid misuse, abuse, and opioid-related fatalities has prompted the development of a number of guidelines for prescribing opioids to patients with chronic noncancer pain, including the recently published US Centers for Disease Control and Prevention Guidelines for Prescribing Opioids for Chronic Pain [1]. These guidelines outline a number of core opioid risk mit...

BACKGROUND Pharmaceutical representative visits are believed to have substantial impact, but the effects on prescribing patterns have not been systematically evaluated. OBJECTIVE This study investigates how pharmaceutical sales representative visits influenced physicians' company-specific drug preferences and prevalence of steroid prescribing. METHODS Observational cohort study in Funen Cou...

The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribin...

BACKGROUND The prescribing cascade model involves the misinterpretation of an adverse reaction to 1 drug and the subsequent, potentially inappropriate prescription of a second drug. We present a new example of the prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs used to manage urinary incontinence. METHODS A population-based retrospective cohort study was carr...