Potentially Inappropriate Medication (PIM) Use in Older Adults: 65 and Older - Independent of Diagnoses or Conditions - Based on Upated Beers Criteria
Potentially Inappropriate Medication (PIM) Use in Older Adults: 65 and Older - Independent of Diagnoses or Conditions - Based on Upated Beers Criteria
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Potentially inappropriate medication use in adults 65 years and older in the United States based on revised and updated 2000 Beers criteria.
The Beers criteria are based on expert consensus developed through an extensive literature review with a
bibliography and questionnaire evaluated by nationally recognized experts in geriatric care, clinical pharmacology, and psychopharmacology using a
modified Delphi technique to reach consensus.
The Beers criteria have been used to survey clinical medication use, analyze computerized administrative data
sets, and evaluate intervention studies to decrease medication problems in older adults.
With the continuous arrival of new drugs on the market, increased knowledge about older drugs, and removal of
older drugs from the market, these criteria go through updates on a regular basis to remain useful. Since the
criteria were published in 1997, there has been an increase in the number of scientific studies addressing
drug use and appropriateness in older adults, but there is still a lack of controlled studies in the older
population and particularly in patients older than 75 years and patients with multiple comorbidities.
An initiative by Donna M. Fick, PhD, RN, et al.to
revise and update the Beers criteria for ambulatory and nursing facility populations older than 65 years in
the United States aimed to:
(1) To reevaluate the 1997 criteria to include new products and incorporate new information available from the
scientific literature.
(2) To assign or reevaluate a relative rating of severity for each of the medications.
(3) To identify any new conditions or considerations not addressed in the 1997 criteria.
The list below contains medications or medication classes that should generally be avoided in persons 65 years
or older because they are either ineffective or they pose unnecessarily high risk for older persons and a
safer alternative is available. They are concluded to be inappropriate to use independent of diagnoses or
conditions and marked with HIGH Severity Rating of Adverse drug events (ADEs).
Table Definitions
Drug Name: is the Drug Brand Name. Other Name (Generic): is the generic name of the drug. Drug Class & Similarity: drug class is listed if the whole class considered high risk. Doses, Exceptions & Other: ranges for high-risk doses, exceptions, and/or other applicable conditions. Concerns and Rules : Link to the concerns about this drug and possible rules use and alternatives.
Aiman Alrawabdeh 5/28/2006
References
[http://archinte.ama-assn.org/cgi/content/full/163/22/2716 Donna M. Fick, PhD, RN, et al. Updating the Beers
Criteria for Potentially Inappropriate Medication Use in Older Adults:Results of a US Consensus Panel of
Experts. Archives of Interal Medicine. 2003;163:2716-2724]
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The Patient: is Male or Female in the USA And Age : 65 years and older And Condition : patient has Only the condition(s) that are intended to be treated by one or more drug listed below And Drug : Brand name, the Generic name or – a drug – from the listed drug classes And Condition (if any) are met under Field “Doses, Exceptions & Other” Then Click on the Link under the Hyper-Link “Concern and Rules” Field marked with the Brand Name: Generic Name To view the concerns about this drug and possible rules use and alternatives
List of Drugs By Brand Name
Drug Name | Other Name (Generic) | Drug Class & Similarity | Doses, Exceptions & Other | Concerns and Rules for Drug_Name:Generic_Name |
---|---|---|---|---|
Adalat | Nifedipine | Similar to:Procardia | Short acting | Adalat:Nifedipine |
Aldomet | Methyldopa | Similar to:Aldoril | NA | Aldomet : Methyldopa |
Aldoril | Methyldopa-hydrochlorothiazide | Similar to:Aldomet | NA | Aldoril : Methyldopa-hydrochlorothiazide |
Aleve | Naproxen | Non-COX-selective NSAIDs (Non-Cyclooxygenase-Selective Nonsteroidal Anti-Inflammatory Drugs) | Long-term use of full-dosage, longer half-life | Aleve : Naproxen |
Amphetamines | Amphetamines | Excluding : Methylphenidate hydrochloride and Excluding : Anorexics | NA | Amphetamines : Amphetamines |