Difference between revisions of "Potentially Inappropriate Medication (PIM) Use in Older Adults: 65 and Older - Independent of Diagnoses or Conditions - Based on Upated Beers Criteria"

Revision as of 23:39, 29 May 2006

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Medication-Based Safety Rules

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

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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Medication-Based Safety Rules

The Rule

 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

Example List of Drugs By Brand Name

For a complete list go to Potentially Inappropriate Medications for Older Adults: 65 and Older