Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria.
OBJECTIVE
To use the most recently available population-based data to estimate potentially inappropriate medication (PIM) prevalence under the 2012 update of the Beers list of PIMs and to provide a benchmark from which to measure future changes.


METHODS
Retrospective cohort study using nationally representative data.


METHODS
2006-2010 Medical Expenditure Panel Survey (MEPS).


METHODS
Community-dwelling sample of U.S. older adults (N=18,475).


METHODS
The updated Beers criteria were operationalized, generating a "broad" PIM definition that incorporated form, route, or dose restrictions where clearly specified and a "qualified" definition that applied specific exceptions where mentioned in the rationale associated with each drug category. Bivariate analyses described PIM prevalence, comparing the two operational definitions, and examined time trends.


RESULTS
Of older adults with prescription medications, 42.6% had at least one medication fill that met the broad definition, with nonsteroidal anti-inflammatory drugs (NSAIDs) having the highest prevalence (10.9%). The rate declined from 45.5% in 2006-2007 to 40.8% in 2009-2010. The categories with the largest absolute decline were NSAIDs, selected sulfonylureas, and estrogens. PIM prevalence was 30.9% using the qualified definition.


CONCLUSIONS
Despite the overall high use of PIMs, there has been a decline observed in recent years. Future studies should test the effect of educational and clinical interventions on changes in PIM use and outcomes. The current study results can aid in targeting these interventions.
School of Public Health, Yale University, New Haven, Connecticut.
Amy J
AJ
Davidoff
G Edward
GE
Miller
Eric M
EM
Sarpong
Eunice
E
Yang
Nicole
N
Brandt
Donna M
DM
Fick
D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment
Beers criteria; MEPS; inappropriate; medication; older adults