Safeguarding Seniors: A Guide to Safer Drug Alternatives

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Advancing Geriatric Care: AGS Unveils Crucial Alternatives to perhaps Inappropriate Medications

New York, NY – The American Geriatrics Society (AGS) has taken a meaningful step forward in enhancing the safety and effectiveness of care for older adults with the release of “Alternative Treatments to Certain Drugs in the 2023 AGS Beers criteria®.” This vital new clinical resource is designed to equip healthcare professionals with evidence-based, safer alternatives to medications identified as potentially inappropriate for the elderly.The newly launched companion tool builds directly upon the foundation of the widely-referenced AGS Beers Criteria® for the Use of Potentially Inappropriate Medications in Older Adults. These criteria, a cornerstone in geriatric pharmacology, pinpoint medications that carry a higher risk of adverse events for seniors not receiving palliative care.”With the AGS Beers Criteria®, we’ve empowered clinicians to identify medications that might pose risks for older patients,” stated Michael Steinman, MD, AGSF, Co-chair of the AGS Beers Criteria® and the panel that developed the alternatives list. “Now, with this updated list of alternatives, we are offering concrete, evidence-based recommendations for non-pharmacological and pharmacological options that clinicians can utilize instead.”

The development of this extensive list involved a dedicated, interdisciplinary working group of experts from diverse clinical specialties and disease areas. Their collective expertise has resulted in an organized compendium of alternatives that are frequently safer and equally, if not more, effective than the medications they aim to replace.crucially, the resource also features additional resources for in-depth guidance, including patient-facing materials and practical tools to facilitate the implementation of these alternative strategies in clinical practice.

according to Todd P.Semla, MS, PharmD, Co-Chair of the alternative list panel and AGS Beers Criteria®, the team approached the task with a patient-centered focus. “We really took a step back and asked ourselves: ‘Where are clinicians likely to face challenges with the Beers Criteria® – and where would clear alternatives be most beneficial?’ The expert panel concentrated on medications where providing alternatives would be most impactful, ensuring we haven’t overlooked any critical areas and that our selections truly reflect the needs of those caring for older adults.”

Paul Mulhausen, MD, MHS, AGSF, President of the AGS, emphasized the practical design of the new resource. “This resource has been developed with the clinician’s needs in mind – from its clear institution to its practical accessibility,” he commented. “I am confident that it will become an essential tool for many of us striving to provide safer and more individualized care for our aging population.”

This initiative underscores the AGS’s unwavering commitment to promoting safer prescribing practices and improving health outcomes for older adults. The “Alternative Treatments to Certain Drugs in the 2023 AGS Beers Criteria®” (DOI: 10.1111/JGS.19500) has been published in the latest edition of the Journal of the American Geriatrics Society (JAGS) and is slated for integration into the readily accessible AGS Beers Criteria® mobile application in the near future, ensuring widespread and convenient availability for healthcare providers.

What non-pharmacological approaches can seniors utilize for pain management as alternatives to opioids?

Understanding Polypharmacy & Senior Health

As we age, the complexity of health needs frequently enough increases, leading to polypharmacy – the use of multiple medications concurrently. While sometimes necessary, polypharmacy significantly elevates the risk of drug interactions, side effects, and adverse events in seniors. This is as of natural age-related changes in how the body processes medications (pharmacokinetics) and responds to them (pharmacodynamics). Understanding these risks is the first step in senior medication management and finding safer drug alternatives.

Why Seniors Are more Vulnerable to Medication Risks

Several factors contribute to increased medication vulnerability in older adults:

Physiological Changes: Kidney and liver function decline with age, impacting drug metabolism and excretion. Reduced body water can concentrate medications, increasing their effects.

Multiple Chronic Conditions: Seniors frequently enough manage several health issues (like arthritis, diabetes, heart disease), requiring multiple prescriptions.

Cognitive Impairment: Memory issues can lead to medication errors – missed doses, double doses, or incorrect administration.

Sensory Decline: Vision and hearing loss can make it arduous to read labels or understand instructions.

Increased Sensitivity: Older adults may be more sensitive to the effects of certain medications.

Non-Pharmacological Alternatives: Starting with Lifestyle

Before turning to medication,or seeking alternatives,explore lifestyle modifications. These can frequently enough effectively manage symptoms and improve quality of life.

Pain Management (Alternatives to Opioids):

Physical Therapy: Strengthens muscles, improves mobility, and reduces pain.

Acupuncture: May provide pain relief by stimulating specific points on the body.

Mindfulness & Meditation: Can definitely help manage chronic pain by altering pain perception.

Heat/Cold Therapy: Simple, effective methods for localized pain relief.

Sleep Issues (Alternatives to Sedatives):

Sleep Hygiene: Establish a regular sleep schedule,create a relaxing bedtime routine,and optimize the sleep environment.

Cognitive Behavioral Therapy for Insomnia (CBT-I): A structured program to address thoughts and behaviors that contribute to insomnia.

Regular Exercise: Promotes better sleep, but avoid strenuous activity close to bedtime.

Anxiety & Depression (Alternatives to Antidepressants/Anxiolytics):

Social Engagement: Maintaining social connections combats loneliness and isolation.

Regular Exercise: Releases endorphins, which have mood-boosting effects.

Talk Therapy: provides a safe space to process emotions and develop coping strategies.

Creative Activities: Engaging in hobbies like painting, music, or writing can reduce stress and improve mood.

Safer Medication Options & Strategies

When medication is necessary, prioritize safer options and strategies:

Deprescribing: Regularly review medications with a healthcare provider to identify and discontinue unnecessary or perhaps harmful drugs. This is a crucial aspect of geriatric pharmacology.

Start Low, Go Slow: Begin with the lowest effective dose and gradually increase it as needed, monitoring for side effects.

Choose Beers Criteria-Avoided Medications: The Beers Criteria lists potentially inappropriate medications for older adults. Your doctor shoudl be aware of this list.

Consider Drug Interactions: Always inform your doctor and pharmacist about all medications, including over-the-counter drugs, supplements, and herbal remedies. Utilize drug interaction checkers (available online through reputable sources like Drugs.com).

Simplified Regimens: Reduce the number of doses and medications to simplify the schedule and minimize errors. Consider using pill organizers.

Formulations: Explore different formulations (liquid, patch, extended-release) that may be easier to administer or have fewer side effects.

Supplements & Herbal Remedies: Proceed with Caution

While some seniors turn to dietary supplements and herbal remedies for health benefits, these are not without risks.

Lack of Regulation: Supplements are not subject to the same rigorous testing and approval process as prescription drugs.

Drug Interactions: Supplements can interact with medications, potentially causing harmful effects. St. John’s Wort, for example, can interfere with many medications.

Quality Control: The quality and purity of supplements can vary significantly.

Always discuss any supplements or herbal remedies with your doctor before use.

The Role of Pharmacists in senior Medication Safety

Pharmacists are invaluable resources for senior medication safety.

* medication Reviews: Pharmacists can conduct comprehensive medication reviews