Potentially Suboptimal Prescribing for Older First Nations Peoples: A Scoping Review

OBJECTIVE: To explore current literature regarding appropriate prescribing for older First Nations Peoples from Australia, the United States of America (USA), Canada and New Zealand residing in the community or residential care facilities (RACF). METHODS: Electronic databases and grey literature sources were searched for literature that focussed on holistic appropriate prescribing and/or potential suboptimal prescribing. Inclusion criteria were First Nations Peoples aged 45 years or older who were community dwelling or residing in RACFs from Australia, the United States, Canada and New Zealand. RESULTS: Sixteen articles were included for analysis. Heterogeneity exists across the findings of potentially suboptimal prescribing concepts. Despite this heterogeneity, this review revealed that potential prescribing omissions appear to have the greatest impact on morbidity and mortality. Factors that increased the risk of potentially suboptimal prescribing included regionality, number of medical conditions, certain disease states and residing in a RACF. CONCLUSION: Health equity and 'closing the gap' for First Nations Peoples is a global issue. This scoping review has shown that potentially suboptimal prescribing and the associated morbidity and mortality are a concern for First Nations Peoples internationally.