• Am J Emerg Med · Sep 2019

    Observational Study

    Potentially inappropriate medication prescribing in the elderly: Is the Beers Criteria relevant in the Emergency Department today?

    • Lindsey Harrison, Emilie O'Connor, Chunfa Jie, Thomas Benzoni, Catherine Hackett Renner, and Ryan McCracken.
    • UnityPoint Health, Office of Research, Des Moines, IA, United States of America.; Des Moines University College of Osteopathic Medicine, Des Moines, IA, United States of America.. Electronic address: lindsey.harrison@unitypoint.org.
    • Am J Emerg Med. 2019 Sep 1; 37 (9): 1734-1737.

    Study ObjectiveTo investigate the frequency of Beers Criteria (BC) medication and opioid use in patients age 65 years and older arriving in the Emergency Department.MethodsWe performed a retrospective observational study of a convenience sample of 400 patients, age 65 years and older, arriving to and discharged solely from the Emergency Department. We examined 400 sequential patient charts with visit dates April-July 2017, for the presence of a Beers Criteria medication or opioid prescription. We also examined each chart for nine specific chief complaints, including return visits and subsequent admissions.ResultsOf the 400 patients included in this study, 304 patients (76%; 95% confidence interval [CI] 72% to 80%) had at least 1 prescription at the index ED visit for an "avoid" or "use with caution" Beers Criteria medication. Of these patients, 194 (64%; 95% CI 58% to 69%) had ≥2 Beers medication prescriptions and 122 patients (40%; 95% CI 35% to 46%) had ≥3 Beers medication prescriptions. We found no difference in the number of patients with a chief complaint of interest between the BC medication list (28%) and lacking a BC medication (29%) (p-value = 1). No patients returned in the next 7 days for a medication-related complaint.ConclusionThe results of this study call into question the routine application of lists without high-quality evidence to critique the prescribing of certain medications. Further patient-oriented study of the relevance of the Beers Criteria list, especially in light of the changed face of medication profiles and populations, is called for.Copyright © 2019. Published by Elsevier Inc.

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