Abstract
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.