Using the Beers criteria to identify potentially inappropriate medication use by older adult dental patients

Abstract

Background: An aging population indicates that increasing numbers of older adults will seek oral health care and have multiple chronic conditions treated with a number of medications. The authors examined the Medicare Current Beneficiary Survey administrative data set to characterize potentially inappropriate medication (PIM) use by older adults visiting the dentist and related adverse experiences that may affect oral health care.

Methods: The authors used the 2015 Beers criteria to identify PIMs for older adults. The authors examined the Medicare Current Beneficiary Survey administrative data set for community-dwelling older adults with dental care visits and reported national prevalence estimates of Beers criteria medication prescribing. The authors used logistic regression to identify sociodemographic and health-related characteristics associated with potentially inappropriate prescribing. The authors described medication-related adverse experiences affecting dental care.

Results: Among older adults with dental care visits, 56.9% received a prescription for at least 1 Beers criteria medication, and 28.3% received a prescription for 2 or more Beers criteria medications. Beers criteria medication use was associated most strongly with the number of comorbid diseases as represented by higher Charlson Index scores (odds ratios, > 1.0).

Conclusions: A substantial proportion of community-dwelling older adults visiting dentists had received prescriptions for 1 or more potentially age-inappropriate Beers criteria medications. Many of these medications have adverse effects that could affect patient safety and oral health care.

Practical implications: These results support the need for clinicians to be aware of PIM use by older adults, recognize associated medication-related adverse events, and avoid prescribing age-inappropriate medications to this vulnerable patient population.

Keywords: Beers criteria; Medicare; Medicare Current Beneficiary Survey; medications; older adults.