· List and explain why specific medications are considered to be potentially inappropriate for use by older adults in general, in specific disease states, in reduced renal function, and in combination with other medications.
· Describe a process used to evaluate the benefits and burdens of medications on the AGS Beers Criteria when used in the context of managing symptoms of advanced illness in older adults.
· Given a simulated case of an older adult receiving hospice or palliative care services, provide an informed decision regarding the use of potentially inappropriate medications selected to treat pain and non-pain symptoms.
The American Geriatrics Society (AGS) “Beers Criteria for Potentially Inappropriate Medication Use in Older Adults” is an often-cited resource regarding the selection of medications for older adults and is frequently used to guide therapeutic decision-making. The purpose of these criteria is to prov...
The American Geriatrics Society (AGS) “Beers Criteria for Potentially Inappropriate Medication Use in Older Adults” is an often-cited resource regarding the selection of medications for older adults and is frequently used to guide therapeutic decision-making. The purpose of these criteria is to provide guidance regarding medications considered to be “potentially inappropriate” in general or in specific disease states, drugs requiring dosage adjustment in renal impairment, and drug-drug interactions. Medications are frequently used to manage pain and non-pain symptoms in older patients with advanced illness, and this frequently involves selection of medications considered to be potentially inappropriate per the Beers criteria. The guidelines clearly state that the intended application is for use in all ambulatory care and institutionalized settings of care for patients over 65, with the exception of hospice and palliative care. However, the guidelines offer prudent advice even in this clinical setting. For example, the AGS Beers Criteria provide a strong recommendation to avoid benzodiazepines, antipsychotic, and anticholinergic (antisecretory) medications in older adults, yet use of these drugs is practically the price of admission to hospice and palliative care. The purpose of this presentation is to summarize the 2015 AGS Beers Criteria, and, using a case-based approach, explore the benefits and burdens of medications on the list when used in the context of advanced illness. This will include medications used in older adults regardless of comorbid conditions, medications used in specific medical conditions, medications that should be used with caution or not at all in older adults, clinically important drug-drug interactions that should be avoided, and medications that should be avoided or dose-reduced in reduced renal function. This is an important presentation that will provide practitioners deeper insight into the benefits and burdens of potentially inappropriate medications often used to manage symptoms in advanced illness in older adults.