Medications
Age-related changes can increase the chances of side effects from medications. The health team monitors all medications, decides if medications are still necessary, and ensures older adults’ medications do not interfere with What Matters, Mentation, or Mobility.
Deprescribe or do not prescribe high-risk meds, considering what matters most.
Based on a representative sampling of 2206 community dwelling older adults:
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87% use at least one prescription medication
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36% use ≥ 5 prescription medications
In a sample of Medicare beneficiaries discharged from an acute care hospital to a SNF:
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Average number of medications prescribed= 14
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Adverse drug events cause up to 30% of hospital admissions for older adults (esp. blood thinners and DM meds)
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Drug-drug interactions (eg. cipro increases warfarin)
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Drug-disease interactions (eg. patients with dementia may become agitated instead of more calm with benzos)
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Prescribing cascades (eg. rx donepezil for dementia GI side effects rx anti-nausea med constipation rx laxatives)
What can we do?
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Review medication list to make sure each medication is necessary.
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Minimize Potentially inappropriate high risk meds such as:
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Benzodiazepines
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Opioids
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Highly-anticholinergic medications (e.g., diphenhydramine)
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All prescription and over-the-counter sedatives and sleep medications
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Muscle relaxants
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Tricyclic antidepressants
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Antipsychotics
American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults Access