An Assessment of Potentially Inappropriate Medications Among the Elderly and the Effect of an Educational Intervention on Provider Knowledge of These Medications

Abstract

Objectives: The aims of this study were to assess potentially inappropriate medications (PIMs) or Beers medications among outpatient older adults within one Midwestern healthcare system, to determine rates of patient education on Beers medications, and to pilot an educational intervention for providers. Methods: This study involved two parts. For part 1 of the study, a randomized retrospective chart review of 493 older adult patients seen in 2017 from four practices was conducted to assess Beers medication prescriptions and rates of patient education. Following the chart review, for part 2 of the study, an educational intervention was delivered to two providers at one practice site on the Beers Criteria and chart review results. A post-test only design was used to determine intervention success. Results: Of the patients included, 64.2% (n = 316) were prescribed a Beers medication during 2017. There were no statistically significant differences for age, gender, or race. A total of 50 different Beers medications were prescribed. The most frequently prescribed drug categories included Proton-pump inhibitors (25.1%), Non-steroidal anti-inflammatory drugs or NSAIDS (18.2%), Benzodiazepines (16%), Anticholinergics (13.6%), and Skeletal muscle relaxants (8.2%). The rate of documented patient education on the risks of the Beers medication(s) was 11.4% (n = 36). Both of the providers who participated in the educational session demonstrated 100% proficiency on the post-test. Conclusion: This study not only demonstrated potentially inappropriate medication prescription trends but also identified a gap in these prescriptions and patient education on the risks associated with the medications. An educational session for providers demonstrated great potential for refreshing memories and/or providing new information on the Beers Criteria and the importance of patient education.