China
Africa
Explore chapters and articles related to this topic
Frailty and multimorbidity
Published in Christopher Dowrick, Global Primary Mental Health Care, 2019
Christos Lionis, Marientina Gotsis
Another goal for FDs when they manage patients with frailty is to reduce unnecessary medications for both cost-savings and adverse effects. The implementation of Beers criteria has been recommended.46 The Screening Tool of Older Persons Prescriptions and Screening Tools to Alert Treatment criteria have also been recommended by a recent review.33
Pharmacological Treatment Approaches
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Catherine G. Derington, David K. Choi, Katy E. Trinkley
Older adults, most often defined as 65 years of age or older, are at higher risk of adverse effects associated with many pain medications as a result of inherent changes associated with aging. As the body ages, reduced absorption from the intestines, increased fat stores, reduced liver enzymes, and reduced kidney function alter the way that the body absorbs, processes, and eliminates drugs from the body. Older adults are more sensitive to the same dose of drugs when compared to younger adults, and they have lower physiologic reserve to handle adverse effects that occur. As such, lower than usual doses should be initiated whenever possible with older adults; drugs with potential to increase fall risk should be avoided whenever possible. The American Geriatrics Society Beers Criteria is an excellent resource for medications, including medications used for pain (e.g., opioids and tricyclic antidepressants (TCAs)) that should be avoided in the elderly because of fall risk, central nervous system depression, or anticholinergic effects (American Geriatrics Society, 2012; Beers Criteria Update Expert Panel, Campanelli, 2012).
Pharmacology in Geriatric Rehabilitation
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Kristin Meyer, Tina Thornhill, Lindsey Garner
Given the complexity of geriatric care, three tools have been developed to assist with identifying and preventing the use of potentially inappropriate medications. The American Geriatric Society Beers’ Criteria is the national standard for quality indicators and geriatric clinical care. These evidence-based criterion were updated in 2015 and now include medications requiring dosage adjustment in renal impairment and select drug–drug interactions known to cause harm in seniors (15). It is important to remember that the Beers Criteria are meant to guide clinicians in selecting medications for senior patients. The Quality of Evidence and Recommendations are based on the general elderly population and may not apply to a specific patient in a special population such as traumatic brain injury.
Psychotropic Use among Older Adults Living at Home: Use of the Anatomical Therapeutic Chemical (ATC) Drug Classification System and Beers Criteria®
Published in Issues in Mental Health Nursing, 2021
G. H. Gunnarsdottir, MS, RN, A. K. Sigurdardóttir, PHD, RN, K. Ólafsson, MA, G. K. Kristofersson, PHD, RN, PMKNP-BC
Treatment of older adults with prescription medications requires skillful and careful prescribers since changes in pharmacokinetics and pharmacodynamics due to age make older adults especially sensitive to side effects (Noble, 2003). Inappropriate medication prescribing is considered a public health issue for older adults due to its association with morbidity and mortality resulting from adverse medication reactions (Fialová et al., 2005; Hart et al., 2019; O’Mahony & Gallagher, 2008). Consequently, criteria have been developed for prescribing appropriate medications for this age group. One of the most acknowledged of these is the American Geriatrics Society (AGS) Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, or the Beers Criteria. The Beers Criteria include five main categories and list potential inappropriate medications that should be avoided or used with caution with older adults (≥65 years) or older adults with certain conditions to reduce adverse medication reactions and polypharmacy in adults (AGS, 2019). The Beers Criteria, first published in 1991, were developed due to inappropriate medication use in nursing homes in the USA (AGS, 2019; Beers et al., 1991). The most recently updated Beers Criteria from 2019 include 30 mediations or medication categories that should be avoided in general for older adults and 40 other medications or medication categories that should be used with caution in this population and in some cases avoided all together (AGS, 2019).
STOPP/START criteria for potentially inappropriate medications/potential prescribing omissions in older people: origin and progress
Published in Expert Review of Clinical Pharmacology, 2020
In late 2003, the third iteration of Beers criteria for potentially inappropriate prescribing (PIP) was published in JAMA [1]. The criteria were first published in 1991 by the late Mark Beers and his colleagues and were initially intended to help prescribers to avoid inappropriate medications in older frailer nursing home residents [2] and were updated in 1997 [3]. The intention of Beers criteria was that they should be suitable for use in any clinical setting that they should be routine in older patients’ medication review and that they should improve clinical outcomes. Beers deserves great credit for formulating and developing the first set of PIP criteria, a much-needed innovation in geriatric pharmacotherapy at the time. Since Beers’ premature death in 2009, the American Geriatrics Society, through an expert US-based panel, has undertaken the task of regular review and updating of Beers criteria which are now in their sixth iteration [4].
Development of a list of high-risk perioperative medications for the elderly: a Delphi method
Published in Expert Opinion on Drug Safety, 2019
Ke Wang, Jianghua Shen, Dechun Jiang, Xiaoxuan Xing, Siyan Zhan, Suying Yan
Perioperative medication management for the elderly population mainly includes pre-operative medication reconciliation and improving post-operative medication compliance. However, the reference basis for medication reconciliation for the elderly population before surgery is very obscure, and there is a lack of direct and targeted evidence. Thus far, there has been no list of high-risk drugs to be administered during the perioperative period, especially in elderly patients. Guidelines only recommend evaluating the disease status of perioperative patients, while drug management is less discussed. For example, the American College of Surgeons (ACS) along with the American Geriatrics Society (AGS) has developed a guideline in 2012, which defined nine assessment categories. For perioperative medication management, they recommend Beers Criteria to minimize the patient risk for adverse drug reactions [8]. The most popular tools to identify potential inappropriate medications (PIMs) in the elderly population are Beers Criteria and STOPP/START criteria. The criteria for PIMs for the elderly population in China was also published in 2017. In addition, perioperative medication management guidelines have been published in some countries, such as the United States [9,10], England [11], and Portugal [12], although these are not specific for the elderly population.