Alternatives to potentially inappropriate medications for use in e-prescribing software: triggers and treatment algorithms

OBJECTIVE To describe the development of evidence-based electronic prescribing (e-prescribing) triggers and treatment algorithms for potentially inappropriate medications (PIMs) for older adults. DESIGN Literature review, expert panel and focus group. SETTING Primary care with access to e-prescribing systems. PARTICIPANTS Primary care physicians using e-prescribing systems receiving medication history. INTERVENTIONS Standardised treatment algorithms for clinicians attempting to prescribe PIMs for older patients. MAIN OUTCOME MEASURE Development of 15 treatment algorithms suggesting alternative therapies. RESULTS Evidence-based treatment algorithms were well received by primary care physicians. Providing alternatives to PIMs would make it easier for physicians to change decisions at the point of prescribing. CONCLUSION Prospectively identifying older persons receiving PIMs or with adherence issues and providing feasible interventions may prevent adverse drug events.