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. 2015 Mar;63(3):486-500.
doi: 10.1111/jgs.13320. Epub 2015 Mar 6.

Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria

Amy J Davidoff  1 , G Edward Miller, Eric M Sarpong, Eunice Yang, Nicole Brandt, Donna M Fick
Affiliations

Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria

Amy J Davidoff et al. J Am Geriatr Soc. 2015 Mar.

Abstract

Objectives: To use the most recently available population-based data to estimate potentially inappropriate medication (PIM) prevalence under the 2012 update of the Beers list of PIMs and to provide a benchmark from which to measure future changes.

Design: Retrospective cohort study using nationally representative data.

Setting: 2006-2010 Medical Expenditure Panel Survey (MEPS).

Participants: Community-dwelling sample of U.S. older adults (N=18,475).

Measurements: The updated Beers criteria were operationalized, generating a "broad" PIM definition that incorporated form, route, or dose restrictions where clearly specified and a "qualified" definition that applied specific exceptions where mentioned in the rationale associated with each drug category. Bivariate analyses described PIM prevalence, comparing the two operational definitions, and examined time trends.

Results: Of older adults with prescription medications, 42.6% had at least one medication fill that met the broad definition, with nonsteroidal anti-inflammatory drugs (NSAIDs) having the highest prevalence (10.9%). The rate declined from 45.5% in 2006-2007 to 40.8% in 2009-2010. The categories with the largest absolute decline were NSAIDs, selected sulfonylureas, and estrogens. PIM prevalence was 30.9% using the qualified definition.

Conclusion: Despite the overall high use of PIMs, there has been a decline observed in recent years. Future studies should test the effect of educational and clinical interventions on changes in PIM use and outcomes. The current study results can aid in targeting these interventions.

Keywords: Beers criteria; MEPS; inappropriate; medication; older adults.

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Conflict of interest statement

Conflicts of Interest: The author(s) received no external financial support for the research and/or authorship of this article.

Figures

FIGURE 1
FIGURE 1
Source: Medical Expenditure Panel Survey, Household Component, Consolidated files, 2006–2010. Note: Individuals may have potentially inappropriate medication use (PIMs) in more than one category.
FIGURE 2
FIGURE 2
Source: Medical Expenditure Panel Survey, Household Component, Consolidated files, 2006–2010. Note: Individuals with multiple potentially inappropriate medications (PIMs) are categorized according the PIM with the highest level of evidence.
See this image and copyright information in PMC

References

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    1. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60:616–631. - PMC - PubMed
    1. Dedhiya SD, Hancock E, Craig BA, et al. Incident use and outcomes associated with potentially inappropriate medication use in older adults. Am J Geriatr Pharmacother. 2010;8:562–570. - PubMed

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