Screening for potentially inappropriate prescribing in primary care: Canadian guideline.

OBJECTIVE

To develop a guideline addressing potentially inappropriate prescribing (PIP) screening in primary care, in accordance with the priority established in Bill C-64 by the Canadian government as part of a strategy for appropriate medication use.

METHODS

The guideline was informed by 2 systematic reviews related to PIP in older adults.

RECOMMENDATIONS: The guideline recommends that adults aged 65 years or older receive prescription checkups or a related intervention to optimize medication appropriateness. Effective interventions include medication reviews paired with suggestions by a prescriber or pharmacist using a structured approach or set of rules (strong recommendation, moderate-certainty evidence). Second, it is recommended that governments fund prescription checkups or related interventions to optimize medication appropriateness (strong recommendation, moderate-certainty evidence).

CONCLUSION

This guideline complements other guidance on how to deprescribe certain medication classes, such as proton pump inhibitors and sedative hypnotics. Interventions should be implemented and funded as part of a pan-Canadian strategy on appropriate medication use, and taken up by provincial, territorial, and federal governments as part of larger strategies to avoid medication-related harms. The effects of interventions should be carefully tracked.