Table 3.

Validated prescribing appropriateness criteria for older Australians (≥65 years) for commonly used medications and medical conditions*,†,‡ (*for usage information for certain criteria, see table 4)

Criteria number	Validated criteria
1	Patient taking an antihypertensive is at the target blood pressure appropriate for them*
2	Patient at high risk of a recurrent cardiovascular event is taking a statin*
3	Patient with CHD or a history of MI is taking a β-blocker
4	Patient with CHD or a history of MI is taking an antiplatelet agent unless taking an oral anticoagulant*
5	Patient with CHD is taking an ACEI or A2A*
6	Patient with stable heart failure with HF-LVSD is taking a β-blocker
7	Patient with stable heart failure with HF-LVSD is taking an ACEI or A2A*
8	Patient with HF-LVSD or HFPEF is NOT taking medications which may exacerbate heart failure*
9	Patient with AF is taking an oral anticoagulant or an antiplatelet agent, depending on stroke risk and bleeding risk*
10	Patient taking warfarin for AF has an INR between 2 and 3
11	Patient with a history of non-haemorrhagic stroke or TIA is taking an antiplatelet agent unless taking an anticoagulant
12	Patient with risk factors for statin-induced myopathy is not taking a high dose of a high-potency statin*
13	Patient with cardiovascular disease is NOT taking an NSAID
14	Patient with cardiovascular, respiratory disease or diabetes who smokes has been offered smoking cessation options*
15	Patient with type 2 diabetes and hypertension and albuminuria is taking an ACEI or A2A
16	Patient with diabetes at high risk of a cardiovascular event is taking an antiplatelet agent unless on an anticoagulant
17	Patient with diabetes taking medications that may affect glycemic control is receiving regular monitoring of blood glucose concentrations*
18	Patient with diabetes has had an HbA1c measurement within the previous 6 months*
19	Patient taking metformin for diabetes has had the dose adjusted for renal function*
20	Patient taking thyroid hormone replacement therapy has had a serum TSH measurement within the previous 12 months
21	Patient with OA pain interfering with daily activities has been trialled on regular paracetamol 2–4 g/day
22	Patient taking analgesic(s) has had the dose(s) titrated in order to avoid pain that interferes with daily activities
23	Patient taking a regular opioid is on prophylactic treatment for constipation
24	Patient with risk factors for impaired renal function is NOT taking an NSAID*
25	Patient is NOT concurrently taking an ACEI or A2A, diuretic and NSAID (excluding low-dose aspirin)
26	Patient has NOT been taking benzodiazepines for >4 weeks*
27	Patient with a history of falls is NOT taking psychotropic medications*
28	Patient taking an SSRI is NOT concurrently taking other medications that may contribute to serotonin toxicity*
29	Patient with dementia is NOT receiving anticholinergic medication*
30	Patient is not taking medication with SIGNIFICANT anticholinergic activity*
31	Patient taking a PPI is NOT taking a medication that may cause dyspepsia unless prescribed for gastroprotection*
32	Patient with COPD is NOT taking benzodiazepines
33	Patient with asthma using an inhaled LABA is also using an inhaled corticosteroid
34	Patient using salbutamol or terbutaline inhaler more than three times per week for reversible airways disease has been prescribed an ICS (except for exercise-induced asthma)
35	Patient with asthma is NOT taking a medication that may worsen asthma*
36	Patient with a UTI is not receiving nitrofurantoin or hexamine for prophylaxis or acute treatment
37	Patient with a non-specific URTI is NOT receiving antibiotics*
38	Patient with osteoporosis is receiving appropriate antiosteoporotic medication*
39	Patient has received influenza and pneumococcal vaccination
40	Patient using topical corticosteroids for contact or allergic dermatitis does not have itch or discomfort that interferes with daily activities
41	Patient has no clinically significant medication interactions (agreement between two medication interaction databases)*

*These criteria are intended to be used by appropriately trained and qualified health professionals, as a tool to assist in making medication management decisions as part of the medication review process.

†Prior to the start of any medication, the contraindications and precautions for that medication should be considered.

‡The intended result of using these criteria is the reasonable and appropriate medication management of individual patients, rather than the systematic application of these criteria to all patients irrespective of other considerations.

A2A, angiotensin 2 receptor antagonist; ACEI, ACE inhibitor; AF, atrial fibrillation; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; HbA1c, glycosylated haemoglobin; HF-LVSD, heart failure with left ventricular systolic dysfunction; HFPEF, heart failure with preserved ejection fraction; ICS, inhaled corticosteroid; INR, international normalised ratio; LABA, long-acting β agonist; MI, myocardial infarct; NSAID, non-steroidal anti-inflammatory drug; OA, osteoarthritis; PPI, proton pump inhibitor; SSRI, selective serotonin reuptake inhibitor; TIA, transient ischaemic attack; TSH, thyroid stimulating hormone; UTI, urinary tract infection; URTI, upper respiratory tract infection.