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Flashcards in Ger 7 Beers Criteria Deck (65)
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1

What are the 4 intentions of the Beers Criteria?

1. Improve the selection of prescription drugs by clinicians and patients
2. Evaluate patterns of drug use within populations
3. Educating clinicians and patients on proper drug usage
4. Evaluating health-outcome, quality of care, cost, and utilization data

2

What will help achieve the goal of evaluating and managing drug use in older adults while considering the dynamic complexities of the healthcare system?

Regular updates to the Beers Critera

3

What supersedes the Beers Criteria list?

1. Clinical judgement
2. Individual patients values and needs

4

What are 2 elements of prescribing and managing disease conditions?

1. Individualization
2. Shared decision making

5

What are 2 examples where a heath care provider determines that a drug on the list is the only reasonable alternative?

1. End of life
2. Palliative care

6

What else can the Beers Criteria be used for besides prescribing medications?

Monitoring their effects in older adults

7

If you choose a drug on the list for an elderly patient, what do you need to do?

Close monitoring for Adverse Drug Effects

*This can be incorporated into the electronic heath record and prevented or detected early

8

What is something else that the Beer Criteria emphasizes the importance of?

Nonpharmacological methods of treatment

9

What are 3 things thoughtful application of the Beers Criteria will allow for?

1. Closer monitoring of drug use
2. Application of real-time e-prescribing and interventions to decrease ADEs in older adults
3. Better patient outcome

10

What is a PIM?

Potentially inappropriate medications

11

What is a systematic review and grading of the evidence on drug-related problems and ADEs in older adults?

Beers Criteria

12

What was used to update the 2012 AGS Beers Critera?

A modified delphi method (EVIDENCE-BASED APPROACH)

13

Who developed the Beers Criteria?

American Geriatrics Society (AGS) and an interdisciplinary panel of 11 experts in geriatric care/pharmacotherapy

14

What are the 3 catergories that medications or medication classes encompassing the update Beers Criteria were placed into?

1. PIM and classes to avoid in older adults
2. PIM and classes to avoid in older adults with certain diseases and syndromes
3. Medications to be used with caution in older adults

15

How many medications or medication classes encompassed the update Beers Criteria?

53

16

What % of ADEs in primary care were preventable according to estimates from past studies in ambulatory and long-term care settings?

27%

17

What % of ADEs in long-term care were preventable according to estimates from past studies in ambulatory and long-term care settings?

42%

18

Where do most problems occur with regards to care?

At the ordering/monitorying stages

19

In the 2000/2001 medical expenditure panel survey, what was the total estimated healthcare expenditures related to the use of PIMs?

7.2 billion

20

What can explicit criteria do?

Identify high-risk drugs using a list of PIMs (by looking at Beers Criteria list

21

When was the first Beers criteria (list of PIMs) for nursing home residents published?

1991

22

What does the revised Beers List of PIMs created in 1997 and 2003 include?

All settings of geriatric care

23

What factors does implicit criteria include (2)?

1. Therapeutic duplication
2. Drug-drug interactions

24

What has a strong link with poor patient outcomes like ADEs, hospitalization, and mortality in observational studies?

PIMs

25

True or False: PIMs have limited effectiveness in older adults

TRUE

26

What are PIMs associated with in older adults?

1. Delirium
2. GI Bleeding
3. Falls
4. Fracture

27

What is the best approach to improve health outcomes in older adults?

LESS IS MORE
*Safer non-pharmacological therapy substituted for use of medications

28

What happens despite the preponderance of information regarding the prevalence of PIM usage (which has been examined in more than 500 studies since early 1990s)?

PIMs are still prescribed and use as 1st line treatment for the most vulnerable of older adults

29

What regulations are PIMs now an integral part of policy and practice in?

Centers for Medicare and Medicaid Services (CMS) regulations
(used in Medicare Part D)

30

What is crucial for the continued use of the Beers criteria as decision-making tools?

Being able to update them quickly and transparently