Abstract
Study objective
To investigate the frequency of Beers Criteria (BC) medication and opioid use in patients
age 65 years and older arriving in the Emergency Department.
Methods
We performed a retrospective observational study of a convenience sample of 400 patients,
age 65 years and older, arriving to and discharged solely from the Emergency Department.
We examined 400 sequential patient charts with visit dates April–July 2017, for the
presence of a Beers Criteria medication or opioid prescription. We also examined each
chart for nine specific chief complaints, including return visits and subsequent admissions.
Results
Of the 400 patients included in this study, 304 patients (76%; 95% confidence interval
[CI] 72% to 80%) had at least 1 prescription at the index ED visit for an “avoid”
or “use with caution” Beers Criteria medication. Of these patients, 194 (64%; 95%
CI 58% to 69%) had ≥2 Beers medication prescriptions and 122 patients (40%; 95% CI
35% to 46%) had ≥3 Beers medication prescriptions. We found no difference in the number
of patients with a chief complaint of interest between the BC medication list (28%)
and lacking a BC medication (29%) (p-value = 1). No patients returned in the next
7 days for a medication-related complaint.
Conclusion
The results of this study call into question the routine application of lists without
high-quality evidence to critique the prescribing of certain medications. Further
patient-oriented study of the relevance of the Beers Criteria list, especially in
light of the changed face of medication profiles and populations, is called for.
Keywords
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Article Info
Publication History
Published online: May 28, 2019
Accepted:
May 27,
2019
Received in revised form:
May 21,
2019
Received:
February 10,
2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
