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geriatric beers care

Ann E Vandenberg, Camille P Vaughan, Melissa Stevens, Susan N Hastings, James Powers, Alayne Markland, Ula Hwang, William Hung, Katharina V Echt
QUALITY PROBLEM OR ISSUE: Clinical decision support (CDS) may improve prescribing for older adults in the Emergency Department (ED) if adopted by providers. INITIAL ASSESSMENT: Existing prescribing order entry processes were mapped at an initial Veterans Administration Medical Center site, demonstrating cognitive burden, effort and safety concerns. CHOICE OF SOLUTION: Geriatric order sets incorporating 2012 Beers guidelines and including geriatric prescribing advice and prepopulated order options were developed...
November 16, 2016: International Journal for Quality in Health Care
Gabrielle Brand, Ashlee Osborne, Mark Carroll, Sandra E Carr, Christopher Etherton-Beer
BACKGROUND: In changing higher education environments, medical educators are increasingly challenged to prepare new doctors to care for ageing populations. The Depth of Field: Exploring Ageing resource (DOF) uses photographs, reflective questioning prompts, older adults' narratives and collaborative dialogue to foster anticipatory reflection or 'preflection' in medical students prior to their first geriatric medicine clinical placement. The aim of this research is to explore whether photographs, narratives and small group collaborative dialogue fosters reflective learning, enhances reflective capacity and has the potential to shift medical students' attitudes towards caring for older adults...
November 11, 2016: BMC Medical Education
Aude Desnoyer, Bertrand Guignard, Pierre-Olivier Lang, Jules Desmeules, Nicole Vogt-Ferrier, Pascal Bonnabry
BACKGROUND: Potentially inappropriate prescriptions include over-prescription, which refers to prescription of more drugs than clinically needed, mis-prescription which refers to incorrect prescription of a drug that is needed (as per drug, dose, drug interactions, duration of therapy, duplication, follow-up, etc.) and under-prescription which stands for failure to prescribe drugs that are needed. They are associated with adverse drug events, increased use of health-care services, morbimortality and health-care costs, and poorer quality of life...
November 2016: La Presse Médicale
Shinya Ishii, Taro Kojima, Kazuhiko Ezawa, Kentaro Higashi, Yukihiko Ikebata, Yozo Takehisa, Masahiro Akishita
AIM: To describe medication use including potentially inappropriate medication (PIM) and examine the association between adverse outcomes and patient factors including PIM use in Japanese elderly patients in long-term care facilities. METHODS: This was a retrospective cohort study of 470 patients in 53 Geriatric Health Service Facilities and 44 Sanatorium Type Medical Care Facilities for the Elderly Requiring Long Term Care. Standardized forms were used to collect information including oral and parenteral medication use on admission, and 1 month and 3 months after admission...
May 26, 2016: Geriatrics & Gerontology International
Nisha C Hazra, Alex Dregan, Stephen Jackson, Martin C Gulliford
OBJECTIVES: To use primary care electronic health records (EHRs) to evaluate prescriptions and inappropriate prescribing in men and women at age 100. DESIGN: Population-based cohort study. SETTING: Primary care database in the United Kingdom, 1990 to 2013. PARTICIPANTS: Individuals reaching the age of 100 between 1990 and 2013 (N = 11,084; n = 8,982 women, n = 2,102 men). MEASUREMENTS: Main drug classes prescribed and potentially inappropriate prescribing according to the 2012 American Geriatrics Society Beers Criteria...
May 2016: Journal of the American Geriatrics Society
Hedva Barenholtz Levy, Esther-Lee Marcus
The 2 most widely used explicit criteria regarding inappropriate medication use in older adults are the American Geriatrics Society's Beers Criteria and the Screening Tool of Older People's Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START). Both documents were updated recently. They are important educational tools that highlight medications for which risks of use may often exceed benefits in older adults and situations in which potentially appropriate medications should be considered for use...
July 2016: Annals of Pharmacotherapy
Brandon T Suehs, Cralen Davis, Billy Franks, Thomas E Yuran, Daniel Ng, Jason Bradt, John Knispel, Maria Vassilakis, Todd Berner
OBJECTIVES: To examine potentially inappropriate medication (PIM) use in older adults initiating an antimuscarinic medication for the treatment of overactive bladder (OAB). DESIGN: Retrospective database analysis. SETTING: Medical and pharmacy claims data. PARTICIPANTS: Medicare Advantage Prescription Drug Plan members aged 65 and older newly initiated on an antimuscarinic OAB treatment were identified and assigned to PIM and non-PIM comparison groups based on 2012 American Geriatrics Society Beers Criteria and/or the presence of an anticholinergic medication interaction at the time of initiation of treatment (N = 66,275)...
April 2016: Journal of the American Geriatrics Society
Jason M Moss, William E Bryan, Loren M Wilkerson, George L Jackson, Ryan K Owenby, Courtney Van Houtven, Melissa B Stevens, James S Powers, Camille P Vaughan, William W Hung, Ula Hwang, Alayne D Markland, Gerald McGwin, Susan Nicole Hastings
BACKGROUND: As the proportion of older adult patients who interface with the health care system grows, clinical pharmacy specialists (CPS) have a pivotal role in reducing potentially inappropriate medication (PIM) use in this population. OBJECTIVES: To (a) describe CPS involvement in the design and implementation of a quality improvement (QI) initiative to decrease PIM prescribing in a Veterans Affairs (VA) emergency department (ED) and (b) report on changes in PIM prescribing before and after the initiative...
January 2016: Journal of Managed Care & Specialty Pharmacy
Kannayiram Alagiakrishnan, Patricia Wilson, Cheryl A Sadowski, Darryl Rolfson, Mark Ballermann, Allen Ausford, Karla Vermeer, Kunal Mohindra, Jacques Romney, Robert S Hayward
BACKGROUND: Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. METHODS: Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers' Criteria for medication management and the Cockcroft-Gault formula for estimating glomerular filtration rates (GFR)...
2016: Clinical Interventions in Aging
Joshua D Brown, Lisa C Hutchison, Chenghui Li, Jacob T Painter, Bradley C Martin
OBJECTIVES: To compare the predictive validity of the 2003 Beers, 2012 American Geriatrics Society (AGS) Beers, and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria. DESIGN: Retrospective cohort. SETTING: Managed care administrative claims data from 2006 to 2009. PARTICIPANTS: Commercially insured persons aged 65 and older in the United States (N=174,275). MEASUREMENTS: Association between adverse drug events (ADEs), emergency department (ED) visits, and hospitalization outcomes and inappropriate medication use using time-varying Cox proportional hazard models...
January 2016: Journal of the American Geriatrics Society
Rosemary Saunders, Karen Miller, Helen Dugmore, Christopher Etherton-Beer
BACKGROUND: Residential aged care environments can provide valuable learning opportunities for health professional education. An aged care community-university partnership developed the Beyond the Teaching Nursing Home: Community Partnership of Learning and Care (BTTNH: CPLC) programme, where older adults volunteer in learning activities with health professional students. This article describes medical students' experience of participating in a clinical learning activity as part of the broader programme...
January 8, 2016: Clinical Teacher
Li Mo, Ding Ding, Shi-Yun Pu, Qin-Hui Liu, Hong Li, Bi-Rong Dong, Xiao-Yan Yang, Jin-Han He
BACKGROUND: Polypharmacy and potentially inappropriate medications (PIMs) are prominent prescribing issues in elderly patients. This study was to investigate the different prevalence of PIM use in elderly inpatients between 65-79 years of age and 80 years or older, who were discharged from Geriatric Department in West China Hospital. METHODS: A large-scale cohort of 1796 inpatients aged 65 years or over was recruited. Respectively, 618 patients were 65-79 years and 1178 patients were 80 years or older...
January 5, 2016: Chinese Medical Journal
Davorka Vrdoljak, Josip Anđelo Borovac
UNLABELLED: The aim of this study was to integrate and present pertinent findings from the literature dealing with the treatment of the elderly within a primary care setting. Medical care for the elderly is an integral part of a general practitioner's (GPs) everyday work and is challenging for many reasons. Older people often experience multiple chronic diseases concurrently (comorbidity, multimorbidity) and they often have deteriorated organ function and decreased physiological reserves due to the natural aging process...
2015: Acta Medica Academica
Hee-Jin Hwang, Sang-Hwan Kim, Kang Soo Lee
BACKGROUND: Elderly residents of long-term care facilities are more vulnerable to being prescribed inappropriate medications because of the high incidence of co-medication in this population resulting from the presence of multiple chronic diseases and also age-related changes in pharmacokinetics and pharmacodynamics. OBJECTIVE: We evaluated the frequency of potentially inappropriate medications and factors influencing their frequency. METHODS: A retrospective cross-sectional study was conducted in 20 long-term care facilities located in the northwest regions of South Korea for 824 patients aged 65 years and older who were assessed between January and February of 2012...
2015: Drugs—Real World Outcomes
Yung-Rung Lai, Yi-Sun Yang, Min-Ling Tsai, Ying-Li Lu, Edy Kornelius, Chien-Ning Huang, Jeng-Yuan Chiou
AIMS: Continuity of care (COC) and potentially inappropriate medication (PIM) can affect the elderly healthcare outcome. We evaluated the COC and PIM effects in older diabetes mellitus (DM) patients with heart failure (HF). METHODS: The Longitudinal Health Insurance Database of 2005 was multiple-year claim data collected from 2005 to 2010 in Taiwan. There were both 823 DM and non-DM subjects aged 65 years and older in this observational study. The COC index and 2012 Beers criteria were applied to evaluate the COC and HF-PIM in older DM patients with heart failure...
October 2016: Geriatrics & Gerontology International
Joseph T Hanlon, Todd P Semla, Kenneth E Schmader
The National Committee for Quality Assurance (NCQA) and the Pharmacy Quality Alliance (PQA) use the American Geriatrics Society (AGS) Beers Criteria to designate the quality measure Use of High-Risk Medications in the Elderly (HRM). The Centers for Medicare and Medicaid Services (CMS) use the HRM measure to monitor and evaluate the quality of care provided to Medicare beneficiaries. NCQA additionally uses the AGS Beers Criteria to designate the quality measure Potentially Harmful Drug-Disease Interactions in the Elderly...
December 2015: Journal of the American Geriatrics Society
(no author information available yet)
The 2015 American Geriatrics Society (AGS) Beers Criteria are presented. Like the 2012 AGS Beers Criteria, they include lists of potentially inappropriate medications to be avoided in older adults. New to the criteria are lists of select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug-drug interactions documented to be associated with harms in older adults. The specific aim was to have a 13-member interdisciplinary panel of experts in geriatric care and pharmacotherapy update the 2012 AGS Beers Criteria using a modified Delphi method to systematically review and grade the evidence and reach a consensus on each existing and new criterion...
November 2015: Journal of the American Geriatrics Society
Michael A Steinman, Judith L Beizer, Catherine E DuBeau, Rosemary D Laird, Nancy E Lundebjerg, Paul Mulhausen
The Beers Criteria are a valuable tool for clinical care and quality improvement but may be misinterpreted and implemented in ways that cause unintended harms. This article describes the intended role of the 2015 American Geriatrics Society (AGS) Beers Criteria and provides guidance on how patients, clinicians, health systems, and payors should use them. A key theme underlying these recommendations is to use common sense and clinical judgment in applying the 2015 AGS Beers Criteria and to remain mindful of nuances in the criteria...
December 2015: Journal of the American Geriatrics Society
Amy Page, Kathleen Potter, Rhonda Clifford, Andrew McLachlan, Christopher Etherton-Beer
INTRODUCTION: Prescribing is complicated for people living with dementia, and careful consideration should be given to continuing and initiating all medicines. This study aims to elicit opinion and gain consensus on appropriate medicine use for people living with dementia in Australia to create a consensus-based list of explicit prescribing criteria. METHODS AND ANALYSIS: A Delphi technique will be used to develop explicit criteria of medication use in adults aged 65 years and above...
2015: BMJ Open
Mitchell R Knisely, Rebecca J Bartlett Ellis, Janet S Carpenter
PURPOSE: The purpose of this article is to identify medication-related considerations for clinical nurse specialist practice by presenting a case report detailing the complexities of medication management, unresolved medication discrepancies, and reconciliation across care transitions. BACKGROUND: Care transitions are a vulnerable time for medication-related problems to occur. Unresolved medication discrepancies can lead to adverse drug events and other poor health outcomes, including hospital readmissions and increased healthcare costs...
September 2015: Clinical Nurse Specialist CNS
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