Selected examples of explicit indicators from the STOPP criteria5
Beta-blocker in combination with verapamil or diltiazem Aspirin with a past history of peptic ulcer disease without concomitant PPI Initiation of tricyclic antidepressants as first-line antidepressant treatment Direct thrombin inhibitors (eg dabigatran) if eGFR<30 mL/min/1.73m2 Systemic corticosteroids instead of inhaled corticosteroids for maintenance therapy in moderate-severe COPD NSAID with established hypertension or heart failure Selective alpha-1 selective alpha blockers in those with symptomatic orthostatic hypotension Oestrogens with a history of breast cancer or venous thromboembolism Use of regular (as distinct from PRN) opioids without concomitant laxative
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Full list of implicit indicators from the Medication Appropriateness Index6
Is there an indication for the drug? Is the medication effective for the condition? Is the dosage correct? Are the directions correct? Are the directions practical? Are there clinically significant drug-drug interactions? Are there clinically significant drug-disease/condition interactions? Is there unnecessary duplication with other drug(s)? Is the duration of therapy acceptable? Is this drug the least expensive alternative compared to others of equal utility?
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