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As summarized in two reviews, a number of investigators in rigorously designed observational studies have shown a strong link between the medications listed in the Beers Criteria and poor patient outcomes (e.g., ADEs, hospitalization, mortality).

Moreover, research has shown that a number of PIMs have limited effectiveness in older adults and are associated with serious problems such as delirium, gastrointestinal bleeding, falls, and fracture.

Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. This article is the foundation for what nursing homes across the United States are using to define inappropriate prescribing.

Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. There is an increased risk for medical and safety consequences, most notably falls, in the elderly population as a result of inappropriate prescribing.

In addition to identifying drugs for which safer pharmacological alternatives are available, in many instances a safer nonpharmacological therapy could be substituted for the use of these medications, highlighting that a “less-is-more approach” is often the best way to improve health outcomes in older adults.

Since the early 1990s, the prevalence of PIM usage has been examined in more than 500 studies, including a number of long-term care, outpatient, acute care, and community settings.

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Of thesepotentially inappropriate drugs, 66 were considered by the panelto have adverse outcomes of high severity.

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This update has much strength, including the use of an evidence-based approach using the Institute of Medicine standards and the development of a partnership to regularly update the Criteria.

Thoughtful application of the Criteria will allow for (a) closer monitoring of drug use, (b) application of real-time e-prescribing and interventions to decrease ADEs in older adults, and (c) better patient outcomes.

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