Reducing Potentially Inappropriate Medication Use for Older Adults in the Emergency Department

Adverse drug events in older adults are pervasive, often harmful, and potentially preventable. There are many reasons for adverse drug events in older adults, including multiple medications, pharmacodynamic changes, pharmacokinetic changes, and age-related issues in various organ systems.

The American Geriatrics Society developed the Beers Criteria, a list of potentially inappropriate medications (PIMs) to guide clinicians in their prescribing practices. For these medications, potential risks may outweigh the benefits.

A recent meta-analysis reported a worldwide prevalence of PIM use of 37%. As older adults often receive care in the emergency department (ED), an ED-specific guideline, the Geriatric Emergency Medication Safety Recommendations (GEMS-Rx) were developed to identify high-risk, potentially avoidable medications commonly prescribed at ED discharge.

In contrast to the Beers Criteria, the GEMS-Rx criteria focus on 8 medication classes commonly prescribed in the ED that may cause harm to older adults discharged to the community.