Problematic Medication Use Still High Among Seniors, but Dropping

The use of potentially inappropriate medications among older people declined between 2006–2007 and 2009–2010, an AHRQ-funded study found. However, there is still an overall high use of such medications, which contributes to poor outcomes and adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most prevalent of the potentially problematic medications. The article and abstract, “Prevalence of Potentially Inappropriate Medication Use in Older Adults Using the 2012 Beers Criteria,” appeared online March 6 in the Journal of the American Geriatrics Society. Coauthors included AHRQ’s G. Edward Miller, Ph.D., and Eric M. Sarpong, Ph.D. The study reported that use of potentially inappropriate medications among older people declined from 45.5 percent in 2006–2007 to 40.8 percent in 2009–2010. Researchers used AHRQ’s 2006–2010 Medical Expenditure Panel Survey data and updated the Beers criteria in the study. The Beers list is a guideline for health care professionals to help improve the safety of prescribing medications for older adults.

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.

Davidoff AJ1, Miller GE, Sarpong EM, Yang E, Brandt N, Fick DM.

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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.