Are you prescribing medications to your elderly patients that may be putting them at higher risk for an adverse drug event? High risk medications (HRMs) are those identified by the Pharmacy Quality Alliance (PQA) and American Geriatrics Society (AGS) Beers Criteria that may cause adverse drug events in the elderly due to the physiological changes associated with aging. These adverse drug events can lead to increased hospitalizations and lengths of stay, increased ED/urgent care visits, falls or fractures, and nursing home placement – all of which can contribute to further physical and social decline in elderly patients.
Carefully evaluate any HRMs currently being prescribed to your elderly patients and consider switching to safer alternatives when appropriate. For some patients, the most effective drug may be one that is considered high risk. If so, it’s important to counsel patients and/or their caregivers about potential side effects to watch out for in order to minimize the risk for a serious adverse drug event from happening.
Below is an adapted list from the AGS Beers Criteria showing some of the most commonly prescribed HRMs. For a comprehensive list or more information on HRM usage in the elderly, visit http://www.americangeriatrics.org/.
References: 1. Department of Health and Human Services. Use of high-risk medications in the elderly: percentage of Medicare members 66 years of age and older who received at least one high-risk medication. https://www.qualitymeasures.ahrq.gov/summaries/summary/49751. Published October 2015. Accessed October 5, 2016. 2. American Geriatrics Society. AGS Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. http://www.americangeriatrics.org/files/documents/beers/BeersCriteriaPublicTranslation.pdf. Published March 2012. Accessed October 5, 2016.