Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Pharmacol. Jun 9, 2015; 4(2): 193-209
Published online Jun 9, 2015. doi: 10.5497/wjp.v4.i2.193
Appropriate prescribing in the elderly: Current perspectives
Amanda Hanora Lavan, John O’Grady, Paul Francis Gallagher
Amanda Hanora Lavan, John O’Grady, Paul Francis Gallagher, Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland
Author contributions: All the authors contributed to this work.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Paul Francis Gallagher, PhD, FRCPI, Consultant Physician, Department of Geriatric Medicine, Cork University Hospital, Cork, Wilton, Co., Cork, Ireland.
Telephone: +353-21-4921302 Fax: +353-21-4922829
Received: July 27, 2014
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

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.