For Older People, Medications Are Common; Novel Criteria Aims To Brand Them Appropriate, Likewise
Wednesday, October 16, 2019
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The American Geriatrics Society (AGS) today unveiled its latest update to i of geriatrics' most often cited reference tools: The AGS Beers Criteria® for Potentially Inappropriate Medication Use inwards Older Adults. With to a greater extent than than 90% of older people using at to the lowest degree i prescription in addition to to a greater extent than than 66% using 3 or to a greater extent than inwards whatsoever given month, the AGS Beers Criteria®--a compendium of medications potentially to avoid or catch amongst caution because they often acquaint an unfavorable residual of benefits in addition to harms for older people--plays a vital role inwards helping wellness professionals, older adults, in addition to caregivers piece of work together to ensure medications are appropriate.
"Medications play an of import role inwards wellness in addition to wellbeing for many older people," noted Donna M. Fick, PhD, RN, FGSA, FAAN, a co-chair of the adept panel responsible for the 2019 AGS Beers Criteria®. "With this novel update, nosotros promise the latest data on what makes medications appropriate for older people tin reach the sack play an as of import role inwards decisions nearly handling options that meets the needs of older adults spell also keeping them as prophylactic as possible."
Published inwards its entirety inwards the Journal of the American Geriatrics Society (DOI: 10.1111/jgs.15767), the AGS Beers Criteria® also includes a host of resources-- from mobile apps to a steal reference card--to assist clinicians implement prescribing recommendations (available from GeriatricsCareOnline.org), as good as tools to assist older adults in addition to caregivers inwards agreement what "potentially inappropriate" medications hateful (available for gratis from HealthinAging.org).
What is the AGS Beers Criteria®?
The AGS Beers Criteria® includes lists of surely medications worth discussing amongst wellness professionals because they may non endure the safest or most appropriate options for older adults. Though non an exhaustive catalogue of inappropriate treatments, the v lists included inwards the AGS Beers Criteria® depict detail medications amongst show suggesting they should be:
- Avoided past times most older people (outside of hospice in addition to palliative aid settings);
- Avoided past times older people amongst specific wellness conditions;
- Avoided inwards combination amongst other treatments because of the adventure for harmful "drug-drug" interactions;
- Used amongst caution because of the potential for harmful side effects; or
- Dosed differently or avoided amidst people amongst reduced kidney function, which impacts how the torso processes medicine.
What's novel inwards 2019?
Influenza A virus subtype H5N1 panel of thirteen experts reviewed to a greater extent than than 1,400 clinical trials in addition to query studies published betwixt 2017 in addition to the final update inwards 2015. Across its v lists, the 2019 AGS Beers Criteria® includes:
- 30 private medications or medication classes to avoid for most older people.
- 40 medications or medication classes to work amongst caution or avoid when someone lives amongst surely diseases or conditions.
- Several changes to medications previously identified as potentially inappropriate. Twenty-five medications or medication classes were dropped outright from the final update to the AGS Beers Criteria® inwards 2015, spell several others were moved to novel categories or had guidance revised based on novel evidence.
"The AGS Beers Criteria® aims to conduct older people in addition to wellness professionals away from potentially harmful treatments spell helping us assess lineament of care," noted Todd Semla, MS, PharmD, BCGP, FCCP, AGSF, also a co-chair of the AGS Beers Criteria® panel for 2019.
"The AGS Beers Criteria® should never entirely dictate how medications are prescribed, nor should it justify restricting wellness coverage. This tool industrial plant best as a starting hollo for for a discussion--one guided past times personal needs in addition to priorities as nosotros age," added Michael Steinman, MD, a beau co-chair of the AGS Beers Criteria® panel.
In back upward of this principle, the AGS Beers Criteria® panelists used their companion editorial (DOI: 10.111/jgs.15766) to reiterate that:
- Potentially inappropriate medications are simply that--potentially inappropriate. They merit special scrutiny but should non endure misconstrued as universally unacceptable inwards all cases or for all people.
- The caveats in addition to rationales informing AGS Beers Criteria® recommendations are as of import as the recommendations themselves. Appreciating these nuances tin reach the sack assist healthcare professionals know why medications are included on the lists, in addition to how approaches to prescribing tin reach the sack endure adjusted accordingly.