Tools to Reduce High-Risk Medication Use in Patients 65 Years and Older

Purpose: With increased use of medications in the elderly, it is important to conduct a medication review at each visit and review changing recommendations for different patient populations. The purpose of this enhancement is to see if a single page, patient led review of medications before each visit can reduce high-risk medication use in patient populations 65 years and older. Methods: For 4 weeks patients 65 years or older were given a summary of high-risk medications per the Beers Criteria prior to each visit. The medications were organized by disease, and the patients were asked to circle any active medications. The physician then reviewed the medication list and made note of which medications could be discontinued, changed, or would remain the same. The number of high-risk medications were recorded before and after the intervention as 0, 1, or 2+. Results: Through this intervention the use of high-risk medications was reduced overall. The intervention also encouraged a scheduled review of high-risk medication recommendations. A reduction of one high-risk medication occurred in >66% of patients and >57% for patients on 2+ high-risk medications. Conclusion: The results suggest a regular review of changing medication recommendations and full medication reviews at yearly appointments can reduce the use of high-risk medications in elderly populations. While the Beers criteria is not a perfect tool, as some medications are needed and cannot be substituted, it is useful as a way to review high-risk medications in elderly patient populations.