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Lack of awareness among emergency physicians of potentially inappropriate medications in elderly patients at EDs

      Adverse drug events are a major cause of preventable hospital admissions and emergency department (ED) visits, particularly among elderly patients due to multimorbidities and polypharmacy [
      • Beijer HJ
      • de Blaey CJ
      Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies.
      ]. Although many of these events are not easily prevented, it is important to reduce inappropriate medication, which can be harmful. Several screening tools to detect potentially inappropriate medications (PIMs) have been developed by geriatric experts in some countries [
      • The American Geriatrics Society
      2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015. Updated Beers Criteria for potentially inappropriate medication use in older adults.
      ,
      • O'Mahony D
      • O'Sullivan D
      • Byrne S
      • O'Connor MN
      • Cristin R
      • Gallagher P
      STOPP/START criteria for potentially inappropriate prescribing in older people: version 2.
      ]. In ED settings, 30% to 80% of elderly patient visits include at least 1 PIM at presentation [
      • Hustey FM
      • Wallis N
      • Miller J
      Inappropriate prescribing in an older ED population.
      ,
      • Gallagher P
      • Lang PO
      • Cherubini A
      • Topinkova E
      • Cruz-Jentoft A
      • Errasquin BM
      • et al.
      Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals.
      ]. Therefore, the American geriatric emergency guidelines have recommended the screening of any high-risk medications using explicit criteria for all elderly patients presenting to the ED, regardless of the presenting complaint [
      • The American College of Emergency Physicians
      • the American Geriatrics Society
      • Emergency Nurses Association
      • the Society for Academic Emergency Medicine
      Geriatric emergency department guidelines.
      ]. Despite the importance of recognizing PIMs, little is known about the awareness of emergency physicians regarding PIMs in elderly patients; therefore, we evaluated this subject. We also determined the prevalence and characteristics of PIMs in elderly patients in ED settings using the updated Beers criteria [
      • The American Geriatrics Society
      2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015. Updated Beers Criteria for potentially inappropriate medication use in older adults.
      ].
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