Medication Use Quality and Safety in Older Adults: 2019 Update.

Nagham J Ailabouni, Zachary A Marcum, Kenneth E Schmader, Shelly L Gray
Author Information
  1. Nagham J Ailabouni: Quality Use of Medicine and Pharmacy Research Centre, UniSA: Clinical & Health Sciences, University of South Australia, Adelaide, Australia.
  2. Zachary A Marcum: Quality Use of Medicine and Pharmacy Research Centre, UniSA: Clinical & Health Sciences, University of South Australia, Adelaide, Australia. ORCID
  3. Kenneth E Schmader: Department of Medicine (Geriatrics), School of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
  4. Shelly L Gray: Department of Pharmacy, University of Washington, Seattle, Washington, USA.

Abstract

Improving the quality of medication use and medication safety are important priorities for prescribers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2019. We selected high-quality studies that moved the field of research forward and were not merely replication studies. The chosen articles cover domains related to aspects of suboptimal prescribing and medication safety. The first study used a nationally representative sample of Medicare beneficiaries to examine the continuation of medications with limited benefit in patients admitted for cancer and non-cancer diagnoses in hospice (domain: potentially inappropriate medications). The second study, a retrospective cohort study of older adults in Ontario, Canada, assessed the association between prescribing oral anticoagulants in an emergency department relative to not prescribing anticoagulants in the emergency department and their persistence at 6 months (domain: underuse of medications). The third study, a cluster randomized trial in Quebec, Canada, evaluated the effect of conducting electronic medication reconciliation on several outcomes including adverse drug events and medication discrepancies (domain: medication safety). Lastly, the fourth study, a retrospective study using national inpatient and outpatient Veteran Health Administration combined with clinical and Medicare Claims data, examined the effects of intensification of antihypertensive medications on older adults' likelihood for hospital re-admission and other important clinical outcomes (domain: medication safety). Collectively, this review succinctly highlights pertinent topics related to promoting safe use of medications and promotes awareness of optimizing older adults' medication regimens.

Keywords

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Grants

  1. K76 AG059929/NIA NIH HHS
  2. P30 AG028716/NIA NIH HHS
  3. Z01 AG000678/Intramural NIH HHS

MeSH Term

Aged, 80 and over
Humans
Medication Therapy Management
Patient Safety
Polypharmacy
Potentially Inappropriate Medication List
Prescription Drugs

Chemicals

Prescription Drugs

Word Cloud

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