Klin Farmakol Farm. 2013;27(1):18-28

Appropriate choice of drugs and drug dosing in geriatric patients (Section I.), drug-disease interactions in the old age (Section II.)

Vhodnost volby léčiv a dávkovacích schémat u geriatrických pacientů (Oddíl I.);

interakce lék&ndash,nemoc ve stáří (Oddíl II.)

Explicit criteria for potentially inappropriate medication use in old age belong to the fundamental instruments of rational prescribing in

geriatric patients and have been widely used in computerized prescribing softwares, educational materials and epidemiological studies.

In the past decades, many explicit criteria were published, particularly with a special focus to rational selection of drugs in geriatric patients,

geriatric dosing, main drug-disease interactions and medications having substantial benefit in geriatric patients and often being

underused. The explicit criteria published are always specific for the pharmaceutical market of the home country and nonspecific for

the drug policy of the Czech Republic (CZ). They include medications not approved in the Czech Republic and some inappropriate medications,

widely used in our country, are not stated. The aim of our research was to develop explicit criteria for medications potentially

inappropriate in old age applicable in the Czech Republic (in the national drug policy, clinical practice and epidemiological studies). The

criteria were developed using a standard 3-round Delphi method, frequently used to create explicit criteria, during a 3-year research

of a team of the Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Prague, Czech Republic (2008–2011) and in a close

cooperation with a multidisciplinary expert group of 15 experts from the fields of geriatrics, internal medicine, general practice medicine,

clinical pharmacy and clinical pharmacology. The criteria for evaluation by the expert group were obtained by literature search of all

explicit criteria of potentially inappropriate prescribing/medications published between 1997–2011 in peer-reviewed journals or jour19

www.klinickafarmakologie.cz | 2013; 27(1) | Klinická farmakologie a farmacie

Hlavní téma

nals with an impact factor. According to a consensus of the expert group, 121 criteria were finally included in the Czech explicit criteria:

74 criteria for medications potentially inappropriate in old age (Section I) and 46 criteria for drug-disease interactions (Section II). The

article summarizes (in a short version) Section I and Section II of the new expert panel criteria for the Czech Republic. It also includes

comments on Section I from the updated Beers criteria published by the American Geriatric Society (AGS) in 2012 and discusses the basic

results of epidemiological studies implementing the 2003 Beers and STOPP/START criteria in the evaluation of rational drug prescribing

in geriatric patients in the Czech Republic.

Keywords: medications potentially inappropriate in the elderly, drug-disease interactions, 2012 Expert Consensus for the Czech Republic

Published: May 15, 2013  Show citation