Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Drugs & Aging
Published in: Drugs & Aging 1/2014

01-01-2014 | Review Article

Recommendations to Prescribe in Complex Older Adults: Results of the CRIteria to Assess Appropriate Medication Use Among Elderly Complex Patients (CRIME) Project

Authors: Graziano Onder, Francesco Landi, Domenico Fusco, Andrea Corsonello, Matteo Tosato, Miriam Battaglia, Simona Mastropaolo, Silvana Settanni, Manuela Antocicco, Fabrizia Lattanzio

Published in: Drugs & Aging | Issue 1/2014

Login to get access

Abstract

The occurrence of several geriatric conditions may influence the efficacy and limit the use of drugs prescribed to treat chronic conditions. Functional and cognitive impairment, geriatric syndromes (i.e. falls or malnutrition) and limited life expectancy are common features of old age, which may limit the efficacy of pharmacological treatments and question the appropriateness of treatment. However, the assessment of these geriatric conditions is rarely incorporated into clinical trials and treatment guidelines. The CRIME (CRIteria to assess appropriate Medication use among Elderly complex patients) project is aimed at producing recommendations to guide pharmacologic prescription in older complex patients with a limited life expectancy, functional and cognitive impairment, and geriatric syndromes, and providing physicians with a tool to improve the quality of prescribing, independent of setting and nationality. To achieve these aims, we performed the following: (i) Existing disease-specific guidelines on pharmacological prescription for the treatment of diabetes, hypertension, congestive heart failure, atrial fibrillation and coronary heart disease were reviewed to assess whether they include specific indications for complex patients; (ii) a literature search was performed to identify relevant articles assessing the pharmacological treatment of complex patients; (iii) A total of 19 new recommendations were developed based on the results of the literature search and expert consensus. In conclusion, the new recommendations evaluate the appropriateness of pharmacological prescription in older complex patients, translating the recommendations of clinical guidelines to patients with a limited life expectancy, functional and cognitive impairment, and geriatric syndromes. These recommendations cannot represent substitutes for careful clinical consideration and deliberation by physicians; the recommendations are not meant to replace existing clinical guidelines, but they may be used to help physicians in the prescribing process.
Appendix
Available only for authorised users
Literature
1.
Lee PG, Cigolle C, Blaum C. The co-occurrence of chronic diseases and geriatric syndromes: the health and retirement study. J Am Geriatr Soc. 2009;57:511–6.PubMedCrossRef
2.
Inouye SK, Studenski S, Tinetti M, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55:780–91.PubMedCentralPubMedCrossRef
3.
Onder G, Lattanzio F, Battaglia M, Cerullo F, Sportiello R, Bernabei R, Landi F. The risk of adverse drug reactions in older patients: beyond drug metabolism. Curr Drug Metab. 2011;12:647–51.PubMedCrossRef
4.
Fusco D, Lattanzio F, Tosato M, Corsonello A, Cherubini A, Volpato S, Maraldi C, Ruggiero C, Onder G. Development of CRIteria to assess appropriate Medication use among Elderly complex patients (CRIME) project: rationale and methodology. Drugs Aging. 2009;26(Suppl 1):3–13.PubMedCrossRef
5.
Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med. 2011;365:2002–12.PubMedCrossRef
6.
Onder G, Petrovic M, Tangiisuran B, Meinardi MC, Markito-Notenboom WP, Somers A, Rajkumar C, Bernabei R, van der Cammen TJ. Development and validation of a score to assess risk of adverse drug reactions among in-hospital patients 65 years or older: the GerontoNet ADR risk score. Arch Intern Med. 2010;170:1142–8.PubMedCrossRef
7.
Tangiisuran B, Davies JG, Wright JE, Rajkumar C. Adverse drug reactions in a population of hospitalized very elderly patients. Drugs Aging. 2012;29:669–79.PubMed
8.
Zhang M, Holman CD, Price SD, Sanfilippo FM, Preen DB, Bulsara MK. Comorbidity and repeat admission to hospital for adverse drug reactions in older adults: retrospective cohort study. BMJ. 2009;338:a2752.PubMedCentralPubMedCrossRef
9.
Beckman AG, Parker MG, Thorslund M. Can elderly people take their medicine? Patient Educ Couns. 2005;59:186–91.PubMedCrossRef
10.
Vetrano DL, Tosato M, Colloca G, Topinkova E, Fialova D, Gindin J, van der Roest HG, Landi F, Liperoti R, Bernabei R, Onder G; SHELTER Study. Polypharmacy in nursing home residents with severe cognitive impairment: results from the SHELTER Study. Alzheimers Dement 2013 Sep;9(5):587-93
11.
Colloca G, Tosato M, Vetrano DL, Topinkova E, Fialova D, Gindin J, van der Roest HG, Landi F, Liperoti R, Bernabei R, Onder G, SHELTER project. Inappropriate drugs in elderly patients with severe cognitive impairment: results from the shelter study. PLoS ONE. 2012;7:e46669.PubMedCentralPubMedCrossRef
12.
Cruz-Jentoft AJ, Boland B, Rexach L. Drug therapy optimization at the end of life. Drugs Aging. 2012;29:511–21.PubMedCrossRef
13.
Wenger NS, Roth CP, Shekelle P, ACOVE Investigators. Introduction to the assessing care of vulnerable elders-3 quality indicator measurement set. J Am Geriatr Soc. 2007;55(Suppl 2):S247–52.PubMedCrossRef
14.
Ray KK, Seshasai SR, Wijesuriya S, et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials. Lancet. 2009;373:1765–72.PubMedCrossRef
15.
Bremer JP, Jauch-Chara K, Hallschmid M, et al. Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabetes Care. 2009;32:1513–7.PubMedCrossRef
16.
Chelliah A, Burge MR. Hypoglycaemia in elderly patients with diabetes mellitus: causes and strategies for prevention. Drugs Aging. 2004;21:511–30.PubMedCrossRef
17.
Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein HC, Miller ME, Byington RP, et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med 2008;358:2545–59
18.
Vijan S, Hofer TP, Hayward RA. Estimated benefits of glycemic control in microvascular complications in type 2 diabetes. Ann Intern Med. 1997;127:788–95.PubMedCrossRef
19.
Huang ES, Zhang Q, Gandra N, et al. The effect of comorbid illness and functional status on the expected benefits of intensive glucose control in older patients with type 2 diabetes: a decision analysis. Ann Intern Med. 2008;149:11–9.PubMedCentralPubMedCrossRef
20.
21.
Monami M, Cresci B, Colombini A. Bone fractures and hypoglycemic treatment in type 2 diabetic patients: a case–control study. Diabetes Care. 2008;31:199–203.PubMedCrossRef
22.
Volpato S, Leveille SG, Blaum C. Risk factors for falls in older disabled women with diabetes: the women’s health and aging study. J Gerontol A Biol Sci Med Sci. 2005;60:1539–45.PubMedCentralPubMedCrossRef
23.
Berlie HD, Garwood CL. Diabetes medications related to an increased risk of falls and fall-related morbidity in the elderly. Ann Pharmacother. 2010;44:712–7.PubMedCrossRef
24.
Nelson JM, Dufraux K, Cook PF. The relationship between glycemic control and falls in older adults. J Am Geriatr Soc. 2007;55:2041–4.PubMedCrossRef
25.
Bruce DG, Davis WA, Casey GP, Clarnette RM, Brown SG, Jacobs IG, Almeida OP, Davis TM. Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study. Diabetologia. 2009;52:1808–15.PubMedCrossRef
26.
Feil DG, Rajan M, Soroka O, Tseng CL, Miller DR, Pogach LM. Risk of hypoglycemia in older veterans with dementia and cognitive impairment: implications for practice and policy. J Am Geriatr Soc. 2011;59:2263–72.PubMedCrossRef
27.
Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP Jr, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009;301:1565–72.PubMedCentralPubMedCrossRef
28.
Bauduceau B, Doucet J, Bordier L, Garcia C, Dupuy O, Mayaudon H. Hypoglycaemia and dementia in diabetic patients. Diabetes Metab. 2010;36(Suppl 3):S106–11.PubMedCrossRef
29.
Brauner DJ, Muir JC, Sachs GA. Treating nondementia illnesses in patients with dementia. JAMA. 2000;283:3230–5.PubMedCrossRef
30.
Grant RW, Devita NG, Singer DE, Meigs JB. Polypharmacy and medication adherence in patients with type 2 diabetes. Diabetes Care. 2003;26:1408–12.PubMedCrossRef
31.
Hewitt J, Smeeth L, Chaturvedi N, Bulpitt CJ, Fletcher AE. Self management and patient understanding of diabetes in the older person. Diabet Med. 2011;28:117–22.PubMedCentralPubMedCrossRef
32.
Wu JS, Yang YC, Lu FH. Population-based study on the prevalence and risk factors of orthostatic hypotension in subjects with pre-diabetes and diabetes. Diabetes Care. 2009;32:69–74.PubMedCrossRef
33.
Luukinen H, Koski K, Laippala P, Kivelä SL. Prognosis of diastolic and systolic orthostatic hypotension in older persons. Arch Intern Med. 1999;159:273–80.PubMedCrossRef
34.
Hiitola P, Enlund H, Kettunen R. Postural changes in blood pressure and the prevalence of orthostatic hypotension among home-dwelling elderly aged 75 years or older. J Hum Hypertens. 2009;23:33–9.PubMedCrossRef
35.
Mangoni AA, Jackson HD. The implications of a growing evidence base for drug use in elderly patients. Part 1. Statins for primary and secondary cardiovascular prevention. Br J Clin Pharmacol. 2006;61:494–501.PubMedCrossRef
36.
Brugts JJ, Yetgin T, Hoeks SE. The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ 2009;338:b2376. doi:10.​1136/​bmj.​b2376.
37.
Heart Protection Study Collaborative, Mihaylova B, Briggs A, Armitage J, Parish S, Gray A, Collins R. Lifetime cost effectiveness of simvastatin in a range of risk groups and age groups derived from a randomised trial of 20,536 people. BMJ 2006;333:1145.
38.
Cholesterol Treatment Trialists' (CTT) Collaborators Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008;371:117–25.
39.
Holmes HM, Sachs GA, Shega JW, Hougham GW, Cox Hayley D, Dale W. Integrating palliative medicine into the care of persons with advanced dementia: identifying appropriate medication use. J Am Geriatr Soc. 2008;56:1306–11.PubMedCrossRef
40.
UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) [published erratum appears in Lancet 1998;352:1558]. Lancet. 1998;352:854–65.CrossRef
41.
Haas L. Management of diabetes mellitus medications in the nursing home. Drugs Aging. 2005;22:209–18.PubMedCrossRef
42.
Neumiller JJ, Setter SM. Pharmacologic management of the older patient with type 2 diabetes mellitus. Am J Geriatr Pharmacother. 2009;7:324–42.PubMedCrossRef
43.
44.
Kapoor JR, Chaudry S, Agostini JV, Foody JA. Systolic hypertension in older persons: how aggressive should treatment be? Prog Cardiovasc Dis. 2006;48:397–406.PubMedCrossRef
45.
Razay G, Williams J, King E, Smith AD, Wilcock G. Blood pressure, dementia and Alzheimer’s disease: the OPTIMA longitudinal study. Dement Geriatr Cogn Disord. 2009;28:70–4.PubMedCrossRef
46.
Nilsson SE, Read S, Berg S, Johansson B, Melander A, Lindblad U. Low systolic blood pressure is associated with impaired cognitive function in the oldest old: longitudinal observations in a population-based sample 80 years and older. Aging Clin Exp Res. 2007;19:41–7.PubMedCrossRef
47.
Molander L, Lövheim H, Norman T, Nordström P, Gustafson Y. Lower systolic blood pressure is associated with greater mortality in people aged 85 and older. J Am Geriatr Soc. 2008;56:1853–9.PubMedCrossRef
48.
Qiu C, Winblad B, Fratiglioni L. The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 2005;4:487–99.PubMedCrossRef
49.
Steinman MA, Goldstein MK. When tight blood pressure control is not for everyone: a new model for performance measurement in hypertension. Jt Comm J Qual Patient Saf. 2010;36:164–72.PubMedCentralPubMed
50.
Vinyoles E, De la Figuera M, Gonzalez-Segura D. Cognitive function and blood pressure control in hypertensive patients over 60 years of age: COGNIPRES study. Curr Med Res Opin. 2008;24:3331–9.PubMedCrossRef
51.
Cooper LA. A 41-year-old African American man with poorly controlled hypertension: review of patient and physician factors related to hypertension treatment adherence. JAMA. 2009;301:1260–72.PubMedCentralPubMedCrossRef
52.
Kassai B, Gueyffier F, Boissel JP, Boutitie F, Cucherat M. Absolute benefit, number needed to treat and gain in life expectancy: which efficacy indices for measuring the treatment benefit? J Clin Epidemiol. 2003;56:977–82.PubMedCrossRef
53.
Mazza A, Ramazzina E, Cuppini S, Armigliato M, Schiavon L, Rossetti C, Marzolo M, Santoro G, Ravenni R, Zuin M, Zorzan S, Rubello D, Casiglia E. Antihypertensive treatment in the elderly and very elderly: always “the lower, the better?”. Int J Hypertens. 2012;2012:590683.PubMedCentralPubMedCrossRef
54.
Montgomery AA, Fahey T, Ben-Shlomo Y, Harding J. The influence of absolute cardiovascular risk, patient utilities, and costs on the decision to treat hypertension: a Markov decision analysis. J Hypertens. 2003;21:1753–9.PubMedCrossRef
55.
Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM, Marra CA. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169:1952–60.PubMedCrossRef
56.
Kamaruzzaman S, Watt H, Carson C, Ebrahim S. The association between orthostatic hypotension and medication use in the British Women’s Heart and Health Study. Age Ageing. 2010;39:51–6.PubMedCrossRef
57.
58.
Butt DA, Mamdani M, Austin PC, Tu K, Gomes T, Glazier RH. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med. 2012;172:1739–44.PubMedCrossRef
59.
Weir RA, McMurray JJ, Puu M, Solomon SD, Olofsson B, Granger CB, Yusuf S, Michelson EL, Swedberg K, Pfeffer MA, CHARM Investigators. Efficacy and tolerability of adding an angiotensin receptor blocker in patients with heart failure already receiving an angiotensin-converting inhibitor plus aldosterone antagonist, with or without a beta blocker. Findings from the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Added trial. Eur J Heart Fail. 2008;10:157–63.PubMedCrossRef
60.
Jneid H, Moukarbel GV, Dawson B, Hajjar RJ, Francis GS. Combining neuroendocrine inhibitors in heart failure: reflections on safety and efficacy. Am J Med 2007;120:1090.e1–8.
61.
Cheng JW, Nayar M. A review of heart failure management in the elderly population. Am J Geriatr Pharmacother. 2009;7:233–49.PubMedCrossRef
62.
Cherubini A, Oristrell J, Pla X, Ruggiero C, Ferretti R, Diestre G, Clarfield AM, Crome P, Hertogh C, Lesauskaite V, Prada GI, Szczerbinska K, Topinkova E, Sinclair-Cohen J, Edbrooke D, Mills GH. The persistent exclusion of older patients from ongoing clinical trials regarding heart failure. Arch Intern Med. 2011;171:550–6.PubMedCrossRef
63.
Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc. 1999;47:40–50.PubMed
64.
Mehagnoul-Schipper DJ, Colier WN, Hoefnagels WH, Verheugt FW, Jansen RW. Effects of furosemide versus captopril on postprandial and orthostatic blood pressure and on cerebral oxygenation in patients > or = 70 years of age with heart failure. Am J Cardiol. 2002;90:596–600.PubMedCrossRef
65.
Ahmed A, Husain A, Love TE, Gambassi G, Dell’Italia LJ, Francis GS, Gheorghiade M, Allman RM, Meleth S, Bourge RC. Heart failure, chronic diuretic use, and increase in mortality and hospitalization: an observational study using propensity score methods. Eur Heart J. 2006;27:1431–9.PubMedCentralPubMedCrossRef
66.
Abdel-Qadir HM, Tu JV, Yun L, Austin PC, Newton GE, Lee DS. Diuretic dose and long-term outcomes in elderly patients with heart failure after hospitalization. Am Heart J. 2010;160:264–71.PubMedCrossRef
67.
Eshaghian S, Horwich TB, Fonarow GC. Relation of loop diuretic dose to mortality in advanced heart failure. Am J Cardiol. 2006;97:1759–64.PubMedCrossRef
68.
Lim LS, Fink HA, Blackwell T, Taylor BC, Ensrud KE. Loop diuretic use and rates of hip bone loss and risk of falls and fractures in older women. J Am Geriatr Soc. 2009;57:855–62.PubMedCentralPubMedCrossRef
69.
Lee DS, Ghosh N, Floras JS, Newton GE, Austin PC, Wang X, Liu PP, Stukel TA, Tu JV. Association of blood pressure at hospital discharge with mortality in patients diagnosed with heart failure. Circ Heart Fail. 2009;2:616–23.PubMedCrossRef
70.
Muzzarelli S, Leibundgut G, Maeder MT, Rickli H, Handschin R, Gutmann M, Jeker U, Buser P, Pfisterer M, Brunner-La Rocca HP, TIME-CHF Investigators. Predictors of early readmission or death in elderly patients with heart failure. Am Heart J. 2010;160:308–14.PubMedCrossRef
71.
Banach M, Bhatia V, Feller MA, Mujib M, Desai RV, Ahmed MI, Guichard JL, Aban I, Love TE, Aronow WS, White M, Deedwania P, Fonarow G, Ahmed A. Relation of baseline systolic blood pressure and long-term outcomes in ambulatory patients with chronic mild to moderate heart failure. Am J Cardiol. 2011;107:1208–14.PubMedCentralPubMedCrossRef
72.
Desai RV, Banach M, Ahmed MI, Mujib M, Aban I, Love TE, White M, Fonarow G, Deedwania P, Aronow WS, Ahmed A. Impact of baseline systolic blood pressure on long-term outcomes in patients with advanced chronic systolic heart failure (insights from the BEST trial). Am J Cardiol. 2010;106:221–7.PubMedCentralPubMedCrossRef
73.
Vidán MT, Bueno H, Wang Y, Schreiner G, Ross JS, Chen J, Krumholz HM. The relationship between systolic blood pressure on admission and mortality in older patients with heart failure. Eur J Heart Fail. 2010;12:148–55.PubMedCrossRef
74.
Gheorghiade M, Abraham WT, Albert NM, Greenberg BH, O’Connor CM, She L, Stough WG, Yancy CW, Young JB, Fonarow GC, OPTIMIZE-HF Investigators and Coordinators. Systolic blood pressure at admission, clinical characteristics, and outcomes in patients hospitalized with acute heart failure. JAMA. 2006;296:2217–26.PubMedCrossRef
75.
Qiu C, Winblad B, Marengoni A, Klarin I, Fastbom J, Fratiglioni L. Heart failure and risk of dementia and Alzheimer disease: a population-based cohort study. Arch Intern Med. 2006;166:1003–8.PubMedCrossRef
76.
Zuccalà G, Onder G, Pedone C, Carosella L, Pahor M, Bernabei R, Cocchi A, GIFA-ONLUS Study Group [Gruppo Italiano di Farmacoepidemiologia nell'Anziano]. Hypotension and cognitive impairment: selective association in patients with heart failure. Neurology. 2001;11(57):1986–92.CrossRef
77.
Spiess JL. Can I stop the warfarin? A review of the risks and benefits of discontinuing anticoagulation. J Palliat Med. 2009;12:83–7.PubMedCrossRef
78.
Kierner KA, Gartner V, Schwarz M, Watzke HH. Use of thromboprophylaxis in palliative care patients: a survey among experts in palliative care, oncology, intensive care, and anticoagulation. Am J Hosp Palliat Care. 2008;25:127–31.PubMedCrossRef
79.
Lurie Y, Loebstein R, Kurnik D, Almog S, Halkin H. Warfarin and vitamin K intake in the era of pharmacogenetics. Br J Clin Pharmacol. 2010;70:164–70.PubMedCrossRef
80.
Sebastian JL, Tresch DD. Use of oral anticoagulants in older patients. Drugs Aging. 2000;16:409–35.PubMedCrossRef
81.
Ansell J, Hirsh J, Hylek E, Jacobson A, Crowther M, Palareti G. Pharmacology and management of the vitamin K antagonists: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008;133:160–98.CrossRef
82.
Kwok CS, Loke YK, Hale R, Potter JF, Myint PK. Atrial fibrillation and incidence of dementia: a systematic review and meta-analysis. Neurology. 2011;76:914–22.PubMedCrossRef
83.
Rose AJ, Hylek EM, Ozonoff A, Ash AS, Reisman JI, Berlowitz DR. Patient characteristics associated with oral anticoagulation control: results of the Veterans AffaiRs Study to Improve Anticoagulation (VARIA). J Thromb Haemost. 2010;8:2182–91.PubMedCrossRef
84.
van Deelen BA, van den Bemt PM, Egberts TC, van 't Hoff A, Maas HA. Cognitive impairment as determinant for sub-optimal control of oral anticoagulation treatment in elderly patients with atrial fibrillation. Drugs Aging. 2005;22:353–60.PubMedCrossRef
85.
Flaker GC, Pogue J, Yusuf S, Pfeffer MA, Goldhaber SZ, Granger CB, Anand IS, Hart R, Connolly SJ; Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events (ACTIVE) Investigators. Cognitive function and anticoagulation control in patients with atrial fibrillation. Circ Cardiovasc Qual Outcomes 2010;3:277–83.
86.
Gage BF, Birman-Deych E, Kerzner R, Radford MJ, Nilasena DS, Rich MW. Incidence of intracranial hemorrhage in patients with atrial fibrillation who are prone to fall. Am J Med. 2005;118:612–7.PubMedCrossRef
87.
Gage BF, Yan Y, Milligan PE, Waterman AD, Culverhouse R, Rich MW, Radford MJ. Clinical classification schemes for predicting hemorrhage: results from the National Registry of Atrial Fibrillation (NRAF). Am Heart J. 2006;151(3):713–9.PubMedCrossRef
88.
Man-Son-Hing M, Nichol G, Lau A, Laupacis A. Choosing antithrombotic therapy for elderly patients with atrial fibrillation who are at risk for falls. Arch Intern Med. 1999;159(7):677–85.PubMedCrossRef
89.
Sellers MB, Newby LK. Atrial fibrillation, anticoagulation, fall risk, and outcomes in elderly patients. Am Heart J. 2011;161(2):241–6.PubMedCrossRef
90.
Kaplan RC, Heckbert SR, Koepsell TD, Furberg CD, Polak JF, Schoen RE, Psaty BM. Risk factors for hospitalized gastrointestinal bleeding among older persons. Cardiovascular Health Study Investigators. J Am Geriatr Soc. 2001;49:126–33.PubMedCrossRef
91.
Stroke prevention in atrial fibrillation study: final results. Circulation 1991;84:527–39
92.
Secondary prevention in non-rheumatic atrial fibrillation after transient ischaemic attack or minor stroke. EAFT (European Atrial Fibrillation Trial) Study Group. Lancet 1993;342:1255–62
93.
Diug B, Evans S, Lowthian J, Maxwell E, Dooley M, Street A, Wolfe R, Cameron P, McNeil J. The unrecognized psychosocial factors contributing to bleeding risk in warfarin therapy. Stroke. 2011;42:2866–71.PubMedCrossRef
94.
Arlt S, Lindner R, Rösler A, von Renteln-Kruse W. Adherence to medication in patients with dementia: predictors and strategies for improvement. Drugs Aging. 2008;25:1033–47.PubMedCrossRef
95.
Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, Kirby A, Sourjina T, Peto R, Collins R, Simes R, Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–78.PubMedCrossRef
96.
Verwoert GC, Mattace-Raso FU, Hofman A, Heeringa J, Stricker BH, Breteler MM, Witteman JC. Orthostatic hypotension and risk of cardiovascular disease in elderly people: the Rotterdam study. J Am Geriatr Soc. 2008;56:1816–20.PubMedCrossRef
97.
Luukinen H, Koski K, Laippala P, Airaksinen KE. Orthostatic hypotension and the risk of myocardial infarction in the home-dwelling elderly. J Intern Med. 2004;255:486–93.PubMedCrossRef
98.
Søgaard P, Thygesen K. Potential proischemic effect of early enalapril in hypotension-prone patients with acute myocardial infarction. The CONSENSUS II Holter Substudy Group. Cardiology. 1997;88:285–91.PubMedCrossRef
99.
Avanzini F, Ferrario G, Santoro L, Peci P, Giani P, Santoro E, Franzosi MG, Tognoni G, Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico-3 Investigators. Risks and benefits of early treatment of acute myocardial infarction with an angiotensin-converting enzyme inhibitor in patients with a history of arterial hypertension: analysis of the GISSI-3 database. Am Heart J. 2002;144:1018–25.PubMedCrossRef
Metadata
Title
Recommendations to Prescribe in Complex Older Adults: Results of the CRIteria to Assess Appropriate Medication Use Among Elderly Complex Patients (CRIME) Project
Authors
Graziano Onder
Francesco Landi
Domenico Fusco
Andrea Corsonello
Matteo Tosato
Miriam Battaglia
Simona Mastropaolo
Silvana Settanni
Manuela Antocicco
Fabrizia Lattanzio
Publication date
01-01-2014
Publisher
Springer International Publishing
Published in
Drugs & Aging / Issue 1/2014
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI
https://doi.org/10.1007/s40266-013-0134-4

Other articles of this Issue 1/2014

Drugs & Aging 1/2014 Go to the issue

Therapy in Practice

Adverse Effects of Clozapine in Older Patients: Epidemiology, Prevention and Management

Therapy in Practice

Catheter-Related Urinary Tract Infection: Practical Management in the Elderly

Erratum

Erratum to: Successes and Failures for Drugs in Late-Stage Development for Alzheimer’s Disease

Review Article

Intermediate Care: The Role of Medicines Management

Adis Drug Evaluation

Regorafenib: A Review of Its Use in Previously Treated Patients with Progressive Metastatic Colorectal Cancer

Original Research Article

Ultra-Long Pharmacokinetic Properties of Insulin Degludec are Comparable in Elderly Subjects and Younger Adults with Type 1 Diabetes Mellitus
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits