Published online Jun 9, 2015. doi: 10.5497/wjp.v4.i2.193
Peer-review started: July 28, 2014
First decision: September 16, 2014
Revised: March 20, 2015
Accepted: May 8, 2015
Article in press: May 11, 2015
Published online: June 9, 2015
Core tip: In this paper we discuss the challenges and complexities of prescribing for older people. We describe the important age-related changes in pharmacokinetics and pharmacodynamics that influence prescribing decisions and we highlight commonly encountered examples of drug-drug and drug-disease interactions. We present a detailed analysis of a complex clinical case in which several instances of potentially inappropriate prescribing exist and we suggest corrective actions. We explore a range of strategies aimed at optimizing prescribing appropriateness for older people including prescribing criteria, comprehensive geriatric assessment, clinical pharmacy interventions and computerized decision supports.