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.