inappropriate prescribing


Summary: The practice of administering medications in a manner that poses more risk than benefit, particularly where safer alternatives exist.

Top Publications

  1. Murray J, Amin P. Overprescribing antibiotics in children: an enduring public health concern. J Spec Pediatr Nurs. 2014;19:266-9 pubmed
  2. . Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. MMWR Morb Mortal Wkly Rep. 2011;60:1487-92 pubmed
    ..Third-party payers can limit reimbursement in ways that reduce inappropriate prescribing, discourage efforts to obtain OPR from multiple health-care providers, and improve clinical care...
  3. MacDonald H, Loder E. Too much medicine: the challenge of finding common ground. BMJ. 2015;350:h1163 pubmed publisher
  4. Lee M, Pan D, Huang J, Chen M, Chong J, Goh E, et al. Results from a Patient-Based Health Education Intervention in Reducing Antibiotic Use for Acute Upper Respiratory Tract Infections in the Private Sector Primary Care Setting in Singapore. Antimicrob Agents Chemother. 2017;61: pubmed publisher
    ..Follow-up studies to investigate differences in responses to educational programs between ethnicities and to explore GP-targeted interventions are recommended. ..
  5. Storms H, Marquet K, Aertgeerts B, Claes N. Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review. Eur J Gen Pract. 2017;23:69-77 pubmed publisher
    ..Prevalence of inappropriate medication use strongly varied, despite similarities in research design and assessment with identical instrument(s). ..
  6. Belfield K, Kuyumjian A, Terán R, Amadi M, Blatt M, Bicking K. Impact of A Collaborative Strategy to Reduce the Inappropriate Use of Acid Suppressive Therapy in Non-Intensive Care Unit Patients. Ann Pharmacother. 2017;51:577-583 pubmed publisher
    ..This intervention resulted in an 87% reduction in drug acquisition costs per patient. A collaboration between clinical pharmacists and a hospitalist service can significantly reduce the inappropriate use of AST in non-ICU patients. ..
  7. Moga D, Abner E, Rigsby D, Eckmann L, Huffmyer M, Murphy R, et al. Optimizing medication appropriateness in older adults: a randomized clinical interventional trial to decrease anticholinergic burden. Alzheimers Res Ther. 2017;9:36 pubmed publisher
    The complexity of medication therapy in older adults with multiple comorbidities often leads to inappropriate prescribing. Drugs with anticholinergic properties are of particular interest because many are not recognized for this property;..
  8. Reardon S. Antibiotic resistance sweeping developing world. Nature. 2014;509:141-2 pubmed publisher
  9. Mack K, Zhang K, Paulozzi L, Jones C. Prescription practices involving opioid analgesics among Americans with Medicaid, 2010. J Health Care Poor Underserved. 2015;26:182-98 pubmed publisher
    ..These indicators have been linked to opioid-related adverse health outcomes, and methods exist to detect and deter inappropriate use and prescribing of opioids. ..

More Information


  1. Teagle A, Powell C. Is fever phobia driving inappropriate use of antipyretics?. Arch Dis Child. 2014;99:701-2 pubmed
  2. Rausch C, Laflamme L, Bultmann U, Moller J. Number of medications and adverse drug events by unintentional poisoning among older adults in consideration of inappropriate drug use: a Swedish population-based matched case-control study. Eur J Clin Pharmacol. 2017;73:743-749 pubmed publisher
    ..Clinicians and patients need to be made aware of the increased likelihood of serious ADE, not only in case of documented inappropriate medications but also in the case of an increasing number of medications. ..
  3. HARRIS A, Hicks L, Qaseem A. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Ann Intern Med. 2016;164:425-34 pubmed publisher
    ..Clinicians should not prescribe antibiotics for patients with the common cold. ..
  4. Flanders S, Saint S. Why does antimicrobial overuse in hospitalized patients persist?. JAMA Intern Med. 2014;174:661-2 pubmed
  5. Andro M, Coutard A, Gentric A. Underuse in elderly adults: an underestimated suboptimal prescribing. J Am Geriatr Soc. 2012;60:1582-3 pubmed publisher
  6. Biondi E, McCulloh R, Alverson B, Klein A, Dixon A, Ralston S. Treatment of mycoplasma pneumonia: a systematic review. Pediatrics. 2014;133:1081-90 pubmed publisher
    ..We identified insufficient evidence to support or refute treatment of M. pneumoniae in CA-LRTI. These data highlight the need for well-designed, prospective RCTs assessing the effect of treating M. pneumoniae in CA-LRTI. ..
  7. Hersh A, Jackson M, Hicks L. Principles of judicious antibiotic prescribing for upper respiratory tract infections in pediatrics. Pediatrics. 2013;132:1146-54 pubmed publisher
    ..The principles can be used to amplify messages from recent clinical guidelines for local guideline development and for patient communication; they are broadly applicable to antibiotic prescribing in general. ..
  8. Mao W, Tang S, Chen W. Does perverse economic incentive lead to the irrational uses of medicines?. Expert Rev Pharmacoecon Outcomes Res. 2013;13:693-6 pubmed publisher
  9. Sikkens J, van Agtmael M, Peters E, Lettinga K, van der Kuip M, Vandenbroucke Grauls C, et al. Behavioral Approach to Appropriate Antimicrobial Prescribing in Hospitals: The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) Participatory Intervention Study. JAMA Intern Med. 2017;177:1130-1138 pubmed publisher
    ..stimulated to choose interventions with higher potential for success based on a root cause analysis of inappropriate prescribing. Appropriateness of antimicrobial prescriptions was determined using a validated approach based on ..
  10. Thiels C, Anderson S, Ubl D, Hanson K, Bergquist W, Gray R, et al. Wide Variation and Overprescription of Opioids After Elective Surgery. Ann Surg. 2017;266:564-573 pubmed publisher
    ..We aimed to identify opioid prescribing practices across surgical specialties and institutions...
  11. Glauser W. Medical-legal concerns over prescribing opioids on the rise. CMAJ. 2017;189:E1270-E1271 pubmed publisher
  12. Zilberberg M, Nathanson B, Sulham K, Fan W, Shorr A. Carbapenem resistance, inappropriate empiric treatment and outcomes among patients hospitalized with Enterobacteriaceae urinary tract infection, pneumonia and sepsis. BMC Infect Dis. 2017;17:279 pubmed publisher
    ..Infection with CRE was associated with a four-fold increased risk of receiving IET, which in turn increased mortality, LOS and costs. ..
  13. Hvistendahl M. Public health. China takes aim at rampant antibiotic resistance. Science. 2012;336:795 pubmed publisher
  14. Hooper D, DeMaria A, Limbago B, O Brien T, McCaughey B. Antibiotic resistance: how serious is the problem, and what can be done?. Clin Chem. 2012;58:1182-6 pubmed publisher
  15. Dowrick C, Frances A. Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ. 2013;347:f7140 pubmed publisher
  16. Hede K. Antibiotic resistance: An infectious arms race. Nature. 2014;509:S2-3 pubmed publisher
  17. Spence D. Are antidepressants overprescribed? Yes. BMJ. 2013;346:f191 pubmed publisher
  18. Gwira Baumblatt J, Wiedeman C, Dunn J, Schaffner W, Paulozzi L, Jones T. High-risk use by patients prescribed opioids for pain and its role in overdose deaths. JAMA Intern Med. 2014;174:796-801 pubmed
    ..Use of prescription drug–monitoring program data to direct risk-reduction measures to the types of patients overrepresented among overdose deaths might reduce mortality associated with opioid abuse. ..
  19. Alvarado A C, Ossa G X, Bustos M L. [Errors in prescriptions and their preparation at the outpatient pharmacy of a regional hospital]. Rev Med Chil. 2017;145:33-40 pubmed publisher
    ..8 times. Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed. ..
  20. Wang D, Lam D, Bellmunt A, Rosenfeld R, Ikeda A, Shin J. Intranasal Steroid Use for Otitis Media with Effusion: Ongoing Opportunities for Quality Improvement. Otolaryngol Head Neck Surg. 2017;157:289-296 pubmed publisher
    ..Related quality improvement opportunities to prevent usage of an ineffective treatment exist. ..
  21. Sönnerstam E, Sjölander M, Gustafsson M. An evaluation of the prevalence of potentially inappropriate medications in older people with cognitive impairment living in Northern Sweden using the EU(7)-PIM list. Eur J Clin Pharmacol. 2017;73:735-742 pubmed publisher
    ..It is important to continuously evaluate the need for potentially inappropriate medications in this patient group, in order to prevent adverse drug reactions, especially among those who have a higher number of medications prescribed. ..
  22. Todd A, Nazar H, Pearson H, Andrew L, Baker L, Husband A. Inappropriate prescribing in patients accessing specialist palliative day care services. Int J Clin Pharm. 2014;36:535-43 pubmed
    ..These patients should have their medication reviewed in the context of life limiting illness aligned with achievable therapeutic outcomes. ..
  23. Suehs B, Davis C, Ng D, Gooch K. Impact of 2015 Update to the Beers Criteria on Estimates of Prevalence and Costs Associated with Potentially Inappropriate Use of Antimuscarinics for Overactive Bladder. Drugs Aging. 2017;34:535-543 pubmed publisher
  24. Goyal M, Johnson T, Chamberlain J, Casper T, Simmons T, Alessandrini E, et al. Racial and Ethnic Differences in Antibiotic Use for Viral Illness in Emergency Departments. Pediatrics. 2017;140: pubmed publisher
    ..Future research should seek to understand why racial and ethnic differences in overprescribing exist, including parental expectations, provider perceptions of parental expectations, and implicit provider bias. ..
  25. Luyt C, Bréchot N, Trouillet J, Chastre J. Antibiotic stewardship in the intensive care unit. Crit Care. 2014;18:480 pubmed publisher
    ..Either we will be able to implement such a policy or we and our patients will face an uncontrollable surge of very difficult-to-treat pathogens. ..
  26. Lindbäck H, Lindback J, Melhus A. Inadequate adherence to Swedish guidelines for uncomplicated lower urinary tract infections among adults in general practice. APMIS. 2017;125:816-821 pubmed publisher
    ..To reduce the selection of multiresistant bacteria, an improvement of the use of diagnostic criteria/tools and antibiotic drugs in primary care is necessary. ..
  27. Daneman N, Campitelli M, Giannakeas V, Morris A, Bell C, Maxwell C, et al. Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities. CMAJ. 2017;189:E851-E860 pubmed publisher
    ..Prescriber audit and feedback may be a promising tool to optimize antibiotic use in long-term care facilities. ..
  28. Wei X, Yin J, Walley J, Zhang Z, Hicks J, Zhou Y, et al. Impact of China's essential medicines scheme and zero-mark-up policy on antibiotic prescriptions in county hospitals: a mixed methods study. Trop Med Int Health. 2017;22:1166-1174 pubmed publisher
    ..We organised independent physician reviews to determine inappropriate prescribing for inpatients...
  29. Choonara I. Rational prescribing is important in all settings. Arch Dis Child. 2013;98:720 pubmed publisher
  30. McCullough A, Pollack A, Plejdrup Hansen M, Glasziou P, Looke D, Britt H, et al. Antibiotics for acute respiratory infections in general practice: comparison of prescribing rates with guideline recommendations. Med J Aust. 2017;207:65-69 pubmed
    ..Antibiotics are prescribed for ARIs at rates 4-9 times as high as those recommended by Therapeutic Guidelines. Our data provide the basis for setting absolute targets for reducing antibiotic prescribing in Australian general practice. ..
  31. Clark D, Schumacher M. America's Opioid Epidemic: Supply and Demand Considerations. Anesth Analg. 2017;125:1667-1674 pubmed publisher
  32. Tillekeratne L, Bodinayake C, Dabrera T, Nagahawatte A, Arachchi W, Sooriyaarachchi A, et al. Antibiotic overuse for acute respiratory tract infections in Sri Lanka: a qualitative study of outpatients and their physicians. BMC Fam Pract. 2017;18:37 pubmed publisher
  33. Milfred LaForest S, Gee J, Pugacz A, Pina I, Hoover D, Wenzell R, et al. Heart Failure Transitions of Care: A Pharmacist-Led Post-Discharge Pilot Experience. Prog Cardiovasc Dis. 2017;60:249-258 pubmed publisher
    ..These encouraging pilot results are hypothesis-generating and warrant further controlled trials. ..
  34. Nishtala P, Salahudeen M. Temporal Trends in Polypharmacy and Hyperpolypharmacy in Older New Zealanders over a 9-Year Period: 2005–2013. Gerontology. 2015;61:195-202 pubmed
    ..Our study provides important information to alert health policy makers, researchers, and clinicians about the dire need to reduce the medication burden in older New Zealanders. ..
  35. Shallcross L, Beckley N, Rait G, Hayward A, Petersen I. Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records. J Antimicrob Chemother. 2017;72:1818-1824 pubmed publisher
    ..Reducing inappropriate antibiotic prescribing in primary care is a public health priority...
  36. Márquez P, Torres O, San José A, Vidal X, Agustí A, Formiga F, et al. Potentially Inappropriate Antihypertensive Prescriptions to Elderly Patients: Results of a Prospective, Observational Study. Drugs Aging. 2017;34:453-466 pubmed publisher
    ..Underprescription was more frequent than overprescription. ACEIs and beta-blockers were frequently underprescribed and were associated with heart failure admissions. ..
  37. Hickner J. Rewriting the script on polypharmacy. J Fam Pract. 2017;66:418 pubmed
    ..With a blood pressure consistently around 105/50 mm Hg, it was an easy decision to stop one of the patient's 3 antihypertensive medications. ..
  38. Pohontsch N, Heser K, Löffler A, Haenisch B, Parker D, Luck T, et al. General practitioners' views on (long-term) prescription and use of problematic and potentially inappropriate medication for oldest-old patients-A qualitative interview study with GPs (CIM-TRIAD study). BMC Fam Pract. 2017;18:22 pubmed publisher
    ..stronger dissemination of the PRISCUS list, better compensation of medication reviews, "positive lists", adequate patient information, multifaceted interventions and improved communication between general practitioners and specialists. ..
  39. Hasan S, Kow C, Verma R, Ahmed S, Mittal P, Chong D. An evaluation of medication appropriateness and frailty among residents of aged care homes in Malaysia: A cross-sectional study. Medicine (Baltimore). 2017;96:e7929 pubmed publisher
    ..2015 Beers' criteria (Potentially Inappropriate Medication [PIM]), and 2014 STOPP criteria (Potentially Inappropriate Prescribing [PIP])...
  40. Inouye S. Enhancing cognitive aging: clinical highlights of a report from the Institute of Medicine. Ann Intern Med. 2015;163:307-10 pubmed publisher
  41. Ballantyne J. Opioids for the Treatment of Chronic Pain: Mistakes Made, Lessons Learned, and Future Directions. Anesth Analg. 2017;125:1769-1778 pubmed publisher
    ..The focus of this article is on what we have learned since opioid treatment of chronic pain was first popularized at the end of the 20th century and how this new information can guide chronic pain management in the future...
  42. Gaynes R, Levy S. Improving outpatient antibiotic prescribing for respiratory tract infections: results of new algorithms used in European trials. Infect Control Hosp Epidemiol. 2015;36:725-9 pubmed publisher
  43. Cole A. GPs feel pressurised to prescribe unnecessary antibiotics, survey finds. BMJ. 2014;349:g5238 pubmed publisher
  44. Vellinga A. The very first requirement of treatment is that it should do no harm, so why are antibiotics still overprescribed?. Int J Clin Pract. 2014;68:152-4 pubmed publisher
  45. Islahudin F, Tamezi A, Shah N. KNOWLEDGE, ATTITUDES AND PRACTICES ABOUT ANTIBIOTIC USE AMONG THE GENERAL PUBLIC IN MALAYSIA. Southeast Asian J Trop Med Public Health. 2014;45:1474-82 pubmed
    ..01). We found the frequency of antibiotic use was related to knowledge about antibiotics among the study population. It is essential to develop educational interventions to correct the misuse and misunderstanding of antibiotics. ..
  46. Cully M. Public health: The politics of antibiotics. Nature. 2014;509:S16-7 pubmed publisher
  47. Sullivan T. Antibiotic overuse and Clostridium difficile: a teachable moment. JAMA Intern Med. 2014;174:1219-20 pubmed publisher
  48. Ahn J, Lee K, Chung J, Shin K, Lee C, Kim H, et al. Clinical characteristics and prognostic risk factors of healthcare-associated pneumonia in a Korean tertiary teaching hospital. Medicine (Baltimore). 2017;96:e8243 pubmed publisher
    ..However, CAP-DRPs and IIAT were not associated with mortality. PSI was the main predictive factor for 28-day mortality in patients with HCAP...
  49. Del Mar C, Scott A, Glasziou P, Hoffmann T, Van Driel M, Beller E, et al. Reducing antibiotic prescribing in Australian general practice: time for a national strategy. Med J Aust. 2017;207:401-406 pubmed
    ..Reducing antibiotic use in Australian general practice will require a range of approaches (with various intervention categories), a sustained effort over many years and a commitment of appropriate resources and support...
  50. Toscani F, Di Giulio P, Villani D, Giunco F, Brunelli C, Gentile S, et al. Treatments and prescriptions in advanced dementia patients residing in long-term care institutions and at home. J Palliat Med. 2013;16:31-7 pubmed publisher
  51. Linder J. Antibiotic Prescribing for acute respiratory infections--success that's way off the mark: comment on "A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis". JAMA Intern Med. 2013;173:273-5 pubmed publisher
  52. Solodiuk J, Curley M. In Defense of Routine Inpatient Pain Assessment. Am J Nurs. 2017;117:11 pubmed publisher
    ..Getting rid of the fifth vital sign won't solve the opioid abuse crisis. ..
  53. Cooper A, Kazis L, Dore D, Mor V, Trivedi A. Underreporting high-risk prescribing among Medicare Advantage plans: a cross-sectional analysis. Ann Intern Med. 2013;159:456-62 pubmed publisher
    ..Medicare Advantage plans underreport rates of high-risk prescribing, suggesting a role for routine audits to ensure the validity of publicly reported quality measures. Health Assessment Lab and National Institute on Aging. ..