The geriatric medication algorithm: a pilot study.

P F Newton, W Levinson, D Maslen
Author Information
  1. P F Newton: Good Samaritan Hospital and Medical Center, Portland, OR 97210.

Abstract

A geriatric medication algorithm designed to reduce inappropriate prescribing was tested in a resident outpatient clinic. The medications of patients over 65 years old taking more than three medications (n = 41) were compared pre- and post-algorithm using the paired t-test. Pre-algorithm, the average number of drugs was 5.8 per patient (SD 1.62). Fifteen medications (6.4%) were discontinued, seven were substituted for a less toxic medication, and five were added. Post-algorithm, the average number of drugs was 5.6 (SD 1.69), mean difference 0.3 (SD 0.67), p < 0.025. Drugs discontinued were more likely to be high risk compared with drugs used at baseline; drugs added were less likely to be high risk. In this pilot study, the authors conclude that the algorithm helps resident physicians reduce inappropriate prescribing.

References

  1. N Engl J Med. 1992 Jul 16;327(3):168-73 [PMID: 1608408]
  2. Med Care. 1991 Oct;29(10):989-1003 [PMID: 1921531]
  3. N Engl J Med. 1987 Feb 12;316(7):363-9 [PMID: 2880292]
  4. J Am Geriatr Soc. 1990 Jan;38(1):31-6 [PMID: 2404053]
  5. Ann Intern Med. 1981 Dec;95(6):711-22 [PMID: 7030165]
  6. J Am Geriatr Soc. 1989 Apr;37(4):323-6 [PMID: 2921453]
  7. Ann Intern Med. 1987 Aug;107(2):169-73 [PMID: 2886086]
  8. Milbank Q. 1989;67(2):268-317 [PMID: 2698446]
  9. Am J Hosp Pharm. 1980 Jan;37(1):92-4 [PMID: 6987865]
  10. J Am Geriatr Soc. 1986 Jan;34(1):1-4 [PMID: 3941238]
  11. N Engl J Med. 1976 Dec 9;295(24):1351-5 [PMID: 988482]
  12. Med Care. 1976 Oct;14(10):799-807 [PMID: 972558]
  13. Ann Intern Med. 1984 Feb;100(2):258-68 [PMID: 6362512]
  14. N Engl J Med. 1989 Aug 3;321(5):303-9 [PMID: 2664519]
  15. Med Care. 1992 Jul;30(7):646-58 [PMID: 1614233]
  16. N Engl J Med. 1983 Jun 16;308(24):1457-63 [PMID: 6406886]
  17. Med Care. 1986 Jun;24(6):472-81 [PMID: 3520177]
  18. Arch Intern Med. 1990 Apr;150(4):841-5 [PMID: 2327844]

MeSH Term

Aged
Algorithms
Drug Prescriptions
Drug Therapy
Geriatrics
Humans
Pilot Projects

Word Cloud

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