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Development of CRIteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) Project

Rationale and Methodology

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Abstract

Pharmacological treatment of complex older adults with comorbidities, multiple impairments in function, cognition, social status and geriatric syndromes represents a challenge for prescribing physicians and often results in a high rate of iatrogenic illnesses. Clinical guidelines are commonly used to indicate appropriate prescription, but they are often based on the results of clinical trials that are conducted on young subjects with a low level of complexity. Therefore, the recommendations of clinical guidelines may be difficult to apply to older complex adults. In this paper we present the rationale and methodology of the Development of CRIteria to assess appropriate Medication use among Elderly complex patients (CRIME) project, a study aimed at producing recommendations to evaluate the appropriateness of pharmacological prescription in older complex patients, translating the recommendations of clinical guidelines to this type of patient. A literature search will be performed to integrate and revise the recommendations of disease-specific guidelines on the pharmacological treatment of patients with common chronic conditions. New recommendations will be provided and approved in a consensus meeting of international experts. Both data from randomized controlled trials and observational studies will be used to meet this aim. Recommendations provided by the CRIME project are not meant to replace existing clinical guidelines, but they may be used to help physicians in the prescribing process. Once completed these recommendations should be validated in interventional studies.

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Acknowledgements

The CRIME project was funded by a grant from the Italian Ministry of Labour, Health and Social Policy (Bando Giovani Ricercatori 2007, convenzione no. 4). The authors have no conflicts of interest that are directly relevant to this review.

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Authors and Affiliations

  1. Centro Medicina dell’Invecchiamento, Dipartimento di Scienze Gerontologiche, Geriatriche e Fisiatriche, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168, Roma, Italy

    Domenico Fusco, Matteo Tosato &  Graziano Onder

  2. Italian National Research Centre on Aging (INRCA), Ancona and Cosenza, Italy

    Fabrizia Lattanzio & Andrea Corsonello

  3. Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy

    Antonio Cherubini & Carmelinda Ruggiero

  4. Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatrics, University of Ferrara, Ferrara, Italy

    Stefano Volpato & Cinzia Maraldi

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  1. Domenico Fusco
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  2. Fabrizia Lattanzio
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  3. Matteo Tosato
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  4. Andrea Corsonello
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  5. Antonio Cherubini
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  6. Stefano Volpato
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  7. Cinzia Maraldi
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  8. Carmelinda Ruggiero
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  9. Graziano Onder
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Correspondence to Graziano Onder.

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Fusco, D., Lattanzio, F., Tosato, M. et al. Development of CRIteria to Assess Appropriate Medication Use among Elderly Complex Patients (CRIME) Project. Drugs Aging 26 (Suppl 1), 3–13 (2009). https://doi.org/10.2165/11534620-000000000-00000

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