||Jagjit Singh, 5/23/2013 4:05:24 AM
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I read with great interest the article on ADRs in the elderly by Dhriti and colleagues.  The authors have done a good job in highlighting the problems of pharmacotherapy in the elderly population. I wish to add a few points in this regard. The authors lament that there are no efforts made at the national and international level to address the problems associated with prescribing in the elderly. However, the development of various criteria for potentially inappropriate medications in elderly by researchers around the world are a proof that this problem is acknowledged globally. [2,3] In particular, Beer’s criteria have been recently modified and adopted by the American Geriatric Society. A list potentially inappropriate drugs available in Indian markets is available.  Another noteworthy development is the European Medicines Agency’s (EMA ) Geriatric Medicines Strategy.  Started in 2006 ,the formal acceptance of the proposals of EMA came in 2011. The basic tenet of the strategy lies in recognizing the fact that the elderly people are the main users of medicines and not a mere minority or a subpopulation. The second goal is to make available the requisite information to both prescribers and patients thereby enhancing safe pharmacotherapy. We look forward eagerly at the outcomes of such endeavours. Meanwhile we should try to collect data in the Indian context to plan effective policies to secure the health of our senior citizens.
1. Brahma DK, Wahlang JB , Marak MD, Sangma MC. Adverse drug reactions in the elderly. J Pharmacol Pharmacother 2013:4;2:91-94
2 Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH . "Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts". Archives of Internal Medicine .2003;163 (22): 2716–2724.
3.Hilary Hamilton, Paul Gallagher, Cristin Ryan, Stephen Byrne, Denis O’Mahony, Potentially Inappropriate Medications Defined by STOPP Criteria and the Risk of Adverse Drug Events in Older Hospitalized Patients. Arch Intern Med. 2011;171 (11):1013-1019.
4.Marcum, Zachary A.; Hanlon, Joseph T. Commentary on the New American Geriatric Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. American Journal of Geriatric Pharmacotherapy. 2012 (10): 151–159.
5.Singh J. Drug use in elderly patients: Are we there yet? J Pharmacol Pharmacother 2011;2:204-6.
6. Cerreta F, Eichler HG, Rasi G. Drug Policy for an Aging Population — The European Medicines Agency’s Geriatric Medicines Strategy. N Engl J Med 2012: 367;21:1972-74