title: Potentially inappropriate medication use: the Beers' Criteria used among older adults with depressive symptoms.
abstract: BACKGROUND
  The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions.
  
  
  OBJECTIVE
  To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms.
  
  
  METHODS
  The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses.
  
  
  RESULTS
  The mean age was 81 (±4.3) years and 59% were women. The median number of medications used was 6 (range 1-21 medications). The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49%) of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale ≥5) and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54).
  
  
  CONCLUSIONS
  Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed.
authors.affiliation: School of Pharmacy, The University of Auckland, Auckland, New Zealand. dlee087@aucklanduni.ac.nz
authors.forename: Daphne
authors.initials: D
authors.lastname: Lee
authors.forename: Nataly
authors.initials: N
authors.lastname: Martini
authors.forename: Simon
authors.initials: S
authors.lastname: Moyes
authors.forename: Karen
authors.initials: K
authors.lastname: Hayman
authors.forename: Monica
authors.initials: M
authors.lastname: Zolezzi
authors.forename: Ngaire
authors.initials: N
authors.lastname: Kerse
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015897:Comorbidity; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D009520:New Zealand; D019338:Polypharmacy; D055553:Prescription Drugs / Q000008:administration & dosage*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D014481:United States
chemical_list: D000928:Antidepressive Agents; D055553:Prescription Drugs