RT Journal
A1 Gnjidic D, Le Couteur DG, Abernethy DR, Hilmer SN
T1 REducing drugs in older adults is more
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2011
FD May 9
VO 171
IS 9
SP 868
OP 869
DO 10.1001/archinternmed.2011.207
UL http://dx.doi.org/10.1001/archinternmed.2011.207
AB 
The application of the GP-GP framework and the assessment of the risks and benefits of the patients' drug therapy were based on the physicians' individual reviews. Estimating the risks of prescribing using this approach may limit the recognition of adverse events in older adults and relies heavily on the experience and knowledge of each physician. To make this algorithm more applicable and generalizable between practitioners, the risk assessment tools based on the drug classes known to increase the risk of adverse events in older adults could be incorporated into the GP-GP algorithm. For example, physicians could use risk assessment tools such as the Drug Burden Index (DBI),2 the Anticholinergic Risk Scale (ARS),3 or the sedative load4 to guide their medication review process. Such tools provide measures of exposure to medicines with anticholinergic and/or sedative effects. The DBI has been associated with impairments in physical and cognitive functions in older adults.2 The feasibility of using the DBI tool alone, without the initial clinical judgment steps of the GP-GP algorithm, to reduce the exposure to anticholinergic and sedative medications in older people was recently tested in a pilot randomized clinical trial.5 The feasibility of using the ARS3 and sedative load4 tools to reduce medication exposure is yet to be investigated in randomized clinical trials.