Suboptimal prescribing in older inpatients and outpatients

Investigators searched Medline and HealthSTAR databases from January 1, 198 5 through June 30, 1999 to identify articles on suboptimal prescribing in t hose age 65 years and older. A manual search of the reference lists from id entified articles and the authors' article files, book chapters, and recent reviews was conducted to identify additional articles. The definitions for various types of suboptimal prescribing (polypharmacy, inappropriate, and underutilization) are numerous, and measurement varies from study to study. The literature suggests that suboptimal prescribing is common in older out patients and inpatients. Moreover, there is significant morbidity and morta lity associated with suboptimal prescribing for these older patients. Evide nce from well-controlled studies suggests that multidisciplinary teams and clinical pharmacy interventions can modify suboptimal drug use in older peo ple. Future research is necessary to measure and test other methods for tac kling this major public health problem facing older people.