Types of screening tools used to identify potential inappropriate medication in the geriatric


  • Marwah Y. Abdullah Department of Family Medicine, East Jeddah Hospital, Jeddah, Saudi Arabia
  • Majed M. Alomari Primary Health Care, Ministry of Health, Mecca, Saudi Arabia
  • Ali N. AlNihab Department of Emergency Medicine, Anak General Hospital, Dammam, Saudi Arabia
  • Maha S. Alshaikh College of Medicine, Ibn Sina National College, Jeddah, Saudi Arabia
  • Maryam A. Alzahrani Primary Health Care, Ministry of Health, Albaha, Saudi Arabia
  • Ali H. Al-Shehab Department of Emergency Medicine, Anak General Hospital, Dammam, Saudi Arabia
  • Munthir H. Alghafli College of Medicine, King Faisal University, Hofuf, Saudi Arabia
  • Ayat E. Shaban Al Nahda Primary Healthcare, Ministry of Health, Jeddah, Saudi Arabia
  • Majed A. Bajaba Al Nahda Primary Healthcare, Ministry of Health, Jeddah, Saudi Arabia
  • Samia S. Al Yateem College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
  • Ahmad A. Alseraihi Department of Cardiology, King Salman Medical City, Medina, Saudi Arabia




Geriatrics, Polypharmacy, Desprescription, Medication, Screening tools, Misbehavior


Inappropriate intake of medications can increase the risk of many morbidities and mortality among the geriatric population. Therefore, assessment of drug underuse, overuse, and inappropriate use has been an area of interest across the different investigations, and according to which, different screening tools were developed to identify these problems and enhance the quality of care to these patients. In the present study, we aim comprehensively discuss the different types of currently reported screening tools that can identify potentially inappropriate medication in the geriatric population. Studies show that assess, review, minimize, optimize, reassess (ARMOR), and medication appropriateness index (MAI) tools are the most commonly reported for this purpose to appropriately evaluate drug administration practices. However, they are time-consuming and need adequately trained personnel, which might not be available within the different settings. Accordingly, we suggest that more than one tool should be used, as we have reviewed all the advantages and disadvantages of the modality within the current study, to adequately facilitate and make the process of evaluation easy and enhance the quality of care for the geriatric population.


Ferrucci L, Giallauria F, Guralnik JM. Epidemiology of aging. Radiol Clinics North Am. 2008;46(4):643-52.

Newman AB, Murabito JM. The epidemiology of longevity and exceptional survival. Epidemiol Rev. 2013;35(1):181-97.

Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: a pathophysiologic approach, ed. McGraw-Hill Medical, New York. 2014.

DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. Pharmacotherapy A Pathophysiologic Approach, 10e. Pharmacotherapy: A Pathophysiologic Approach 10e New York: McGraw-Hill Education. 2017;255-8.

Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2012;60(10):1-25.

Zullo AR, Gray SL, Holmes HM, Marcum ZA. Screening for Medication Appropriateness in Older Adults. Clin Geriatr Med. 2018;34(1):39-54.

Bulloch MN, Olin JL. Instruments for evaluating medication use and prescribing in older adults. J Am Pharmacists Assoc. 2014;54(5):530-7.

Cassels A. 'Can I stop even one of these pills?' The development of a tool to make deprescribing easier. Eur J Hospital Pharm. 2017;24(1):3-4.

Vinks TH, Egberts TC, de Lange TM, de Koning FH. Pharmacist-based medication review reduces potential drug-related problems in the elderly: the SMOG controlled trial. Drugs Aging. 2009;26(2):123-33.

Vinks TH, de Koning FH, de Lange TM, Egberts TC. Identification of potential drug-related problems in the elderly: the role of the community pharmacist. Pharm World Sci. 2006;28(1):33-8.

Van Cuong L, Giang HTN, Linh LK. The first Vietnamese case of COVID-19 acquired from China. Lancet Infect Dis. 2020;20(4):408-9.

Dibas M, Doheim MF, Ghozy S, Ros MH, El-Helw GO, Reda A. Incidence and survival rates and trends of skull Base chondrosarcoma: A Population-Based study. Clin Neurol Neurosurg. 2020;198:106153.

Lee SS, Schwemm AK, Reist J. Pharmacists' and pharmacy students' ability to identify drug-related problems using TIMER (Tool to Improve Medications in the Elderly via Review). Am J Pharm Educ. 2009;73(3):52.

Haque RU. ARMOR: A Tool to Evaluate Polypharmacy in Elderly Persons. Ann Long-Term Care. 2009;17:26-30.

Thieu H, Bach Dat B, Nam NH. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Medica. 2020;111(5):498-501.

El-Qushayri AE, Ghozy S, Reda A, Kamel AMA, Abbas AS, Dmytriw AA. The impact of Parkinson's disease on manifestations and outcomes of Covid-19 patients: A systematic review and meta-analysis. Rev Med Virol. 2021;e2278.

Shrank WH, Polinski JM, Avorn J. Quality indicators for medication use in vulnerable elders. J Am Geriatr Soc. 2007;55(2):373-82.

Wenger NS, Roth CP, Shekelle P. Introduction to the assessing care of vulnerable elders-3 quality indicator measurement set. J Am Geriatr Soc. 2007;55(2):247-52.

Askari M, Wierenga PC, Eslami S, Medlock S, de Rooij SE, Abu-Hanna A. Assessing quality of care of elderly patients using the ACOVE quality indicator set: a systematic review. PloS One. 2011;6(12):e28631.

Son PT, Reda A, Viet DC, Quynh NXT, Hung DT, Tung TH, Huy NT. Exchange transfusion in the management of critical pertussis in young infants: a case series. Vox Sang. 2021;116(9):976-82.

Nguyen TM, Huan VT, Reda A. Clinical features and outcomes of neonatal dengue at the Children’s Hospital 1, Ho Chi Minh, Vietnam. J Clin Virol. 2021;138:104758.

Garfinkel D, Zur-Gil S, Ben-Israel J. The war against polypharmacy: a new cost-effective geriatric-palliative approach for improving drug therapy in disabled elderly people. The Israel Med Assoc J. 2007;9(6):430-4.

El-Qushayri AE, Dahy A, Reda A. A closer look at the high burden of psychiatric disorders among healthcare workers in Egypt during the COVID-19 pandemic. Epidemiol Health. 2021;43(0):e2021045.

Pham TS, Reda A, Ngan Nguyen TT, Ng SJ, Huan VT, Viet DC, Huy NT. Blood exchange transfusion in viral hepatitis in a small infant: a case report. Transfus Apher Sci. 2020;59(6):102907.

Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Int Med. 2010;170(18):1648-54.

Wright RM, Sloane R, Pieper CF. Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study. Am J Geriatr Pharmacother. 2009;7(5):271-80.

Steinman MA, Landefeld CS, Rosenthal GE, Berthenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 2006;54(10):1516-23.

Hanlon JT, Schmader KE, Samsa GP. A method for assessing drug therapy appropriateness. J Clin Epidemiol. 1992;45(10):1045-51.

Kassam R, Martin LG, Farris KB. Reliability of a modified medication appropriateness index in community pharmacies. Ann Pharmacother. 2003;37(1):40-6.

Samsa GP, Hanlon JT, Schmader KE, Weinberger M, Clipp EC, Uttech KM, Lewis IK, Landsman PB, Cohen HJ. A summated score for the medication appropriateness index: development and assessment of clinimetric properties including content validity. J Clin Epidemiol. 1994;47(8):891-6.

Lund BC, Carnahan RM, Egge JA, Chrischilles EA, Kaboli PJ. Inappropriate prescribing predicts adverse drug events in older adults. Ann Pharmacother. 2010;44(6):957-63.

Fitzgerald LS, Hanlon JT, Shelton PS. Reliability of a modified medication appropriateness index in ambulatory older persons. Ann Pharmacother. 1997;31(5):543-8.

Somers A, Mallet L, van der Cammen T, Robays H, Petrovic M. Applicability of an adapted medication appropriateness index for detection of drug-related problems in geriatric inpatients. Am J Geriatr Pharmacother. 2012;10(2):101-9.

Hanlon JT, Weinberger M, Samsa GP. A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy. Am J Med. 1996;100(4):428-37.




How to Cite

Abdullah, M. Y., Alomari, M. M., AlNihab, A. N., Alshaikh, M. S., Alzahrani, M. A., Al-Shehab, A. H., Alghafli, M. H., Shaban, A. E., Bajaba, M. A., Yateem, S. S. A., & Alseraihi, A. A. (2022). Types of screening tools used to identify potential inappropriate medication in the geriatric. International Journal Of Community Medicine And Public Health, 9(2), 1000–1004. https://doi.org/10.18203/2394-6040.ijcmph20220005



Review Articles