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Beyond the beers criteria: A comparative overview of explicit criteria.

Authors: Hedva Barenholtz, Levy; Esther-Lee, Marcus; Catherine, Christen;

Beyond the beers criteria: A comparative overview of explicit criteria.

Abstract

To provide a comparative overview of explicit criteria that have been developed since 2003 for inappropriate prescribing in older adults and to contrast these newer criteria with the most recent Beers criteria, published in 2003.MEDLINE and Google Scholar searches were performed from 2003 through July 2010. Within MEDLINE, MeSH terms included aged, drug prescriptions, medication errors, and polypharmacy. Free-text search terms included elderly, guideline adherence, inappropriate prescribing, and medications. Related articles, as identified by MEDLINE, were used as well. Free-text search was performed on Google Scholar, using "potentially inappropriate prescribing elderly." Additional articles were identified in reference lists of key articles.Studies were selected if they were published after the most recent revision of the Beers criteria in 2003 and addressed the development and application of explicit criteria for the elderly. We independently reviewed pertinent literature to extract key information.The first explicit criteria published were the Beers criteria, and most research regarding inappropriate medication use applied these criteria. Criteria developed subsequent to the Beers criteria include the French Consensus Panel list, STOPP (Screening Tool of Older Persons' Prescription) and START (Screening Tool to Alert doctors to Right Treatment), the Australian Prescribing Indicators tool, and the Norwegian General Practice Criteria. Newer criteria offer several improvements on the Beers criteria, namely drug-drug interactions, omission of potentially beneficial therapy, and more broadly applicable criteria across international borders.Although no criteria may ever be globally applicable, STOPP and START make significant advances. Regional drug availability, economic considerations, and clinical practice patterns impact criteria selection. Research to validate the several newer criteria in various practice settings and to explore the effect of adhering to the guidelines on patient outcomes is warranted. Data from such research will aid practitioners in identifying preferred criteria.

Keywords

Clinical Protocols, Polypharmacy, Humans, Medication Errors, Inappropriate Prescribing, Practice Patterns, Physicians', Aged

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citations
The total number of citations received by all articles of the researcher of interest.
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
92
Top 10%
Top 10%
Top 1%
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