Items in AFP with MESH term: Health Services for the Aged
Group Visits Hit the Road - Feature
What Physicians Need to Know About Seniors and Limited Prescription Benefits, and Why - Graham Center Policy One-Pagers
Family Physicians Are the Main Source of Primary Health Care for the Medicare Population - Graham Center Policy One-Pagers
Family Physicians' Present and Future Role in Caring for Older Patients - Graham Center Policy One-Pagers
Refocusing Geriatricians' Role in Training to Improve Care for Older Adults - Graham Center Policy One-Pagers
ABSTRACT: Adverse drug events occur in 15 percent or more of older patients presenting to offices, hospitals, and extended care facilities. These events are potentially preventable up to 50 percent of the time. Common serious manifestations include falls, orthostatic hypotension, heart failure, and delirium. The most common causes of death are gastrointestinal or intracranial bleeding and renal failure. Antithrombotic and antidiabetic medications, diuretics, and nonsteroidal anti-inflammatory drugs cause most of the preventable hospital admissions due to adverse drug events. Strategies to reduce the risk of adverse drug events include discontinuing medications, prescribing new medications sparingly, reducing the number of prescribers, and frequently reconciling medications. The Beers, STOPP (screening tool of older persons’ potentially inappropriate prescriptions), and START (screening tool to alert doctors to right treatment) criteria can help identify medications causing adverse drug events. Not all potentially inappropriate medications can be avoided. Clinicians should involve patients in shared decision making and individualize prescribing decisions based on medical, functional, and social conditions; quality of life; and prognosis.