This paper defines our current understanding of appropriate prescribing and outlines the potential hazards of over-prescribing for older people, while acknowledging the benefits of modern pharmacological treatment.

It considers the major problem of polypharmacy, as well as inappropriate prescribing, for the elderly, a challenge that contributes to costs, adverse drug events, confusion, compliance issues, and errors in management.

A systematic approach to drug monitoring is an important aspect of appropriate prescribing. Attention to prescribing of medications, consistent review of medication lists, and re-evaluation of indications and outcomes of prescribing are essential to ensure that polypharmacy is minimised and safety for patients is maximised.

As well as defining our current understanding and potential hazards, the paper goes on to discuss practical strategies to attempt to achieve optimal prescribing patterns for the elderly and acts as a practical review for caregivers in multiple practice situations including acute care hospitals, outpatient settings, long-term care, and home care.