Saturday 9 June 2012

Avoiding inappropriate medication in the elderly

Lesson #1 of being a geriatrician? Stop hazardous drugs.

The Beers criteria (named after the late Dr Mark Beers) is used by the American Geriatrics Society to compile a list of Potentially Inappropriate Medication use in the Elderly.

Scott Gavura of Science Based Medicine has blogged a useful summary of the latest version of Beers criteria. He goes on to call for wider use of something from the geriatrician's therapeutic tool box - stopping medication.

"Some physicians and geriatricians call for more efforts at deprescribing or “drugectomies” as a means of reducing drug-related harms in the elderly: Ruthlessly discontinuing drug therapies if the expected clinical benefits are small. The approach involves a careful consideration of each drug, confirming that it’s still medically appropriate and necessary, while considering patient preferences and overall quality of life. As data emerges suggesting these approaches look promising, we may see more standardized approaches to deprescribing in the future."

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