The use of “potentially inappropriate medications” (PIMs) among older adults has been increasing over the past two decades, but with little attention in the media. PIMs are drugs that have potential adverse risks which exceed the expected benefits. Studies have shown that “PIM use in older patients is closely related to an increase in the incidence of adverse drug events (ADEs) and emergency department visits.”1-2 This also comes with increased outpatient visits, drug fees and risk of hospitalization.
Disturbing Research
A recent systematic review3 analyzed 94 articles that included nearly 371 million patients from 17 countries to determine the prevalence of PIMs use. Globally, PIMs use is 36.7%. Here is the prevalence broken down by region:
If we only consider North America, this means that it is likely that almost a third of your older patients’ prescriptions are for drugs that are more dangerous to their health than they are beneficial. PIMs prevalence increases if they are male (41%), over 80 years of age (42%) or taking five or more prescriptions (46%). Needless to say, a combination of these factors increases the prevalence even more.
The Beers Criteria is an expert consensus on PIMs. The American Geriatrics Society regularly reviews and updates the Beers Criteria, which is now in its sixth iteration. Every MD in the country should be aware of which drugs are included in PIMs for older adults.
Not Your Job? Wrong
While your first reaction may be that this is “not my job,” you are in a position to have conversations with your senior patients that can keep them out of the hospital and perhaps even extend their lives. A few minutes of discussion will help make them aware of the potential harm they may be facing and hopefully result in a more informed inquiry with their medical doctor.
At the very least, you can show them how to access the complete study, which is available to the public online and generally easy to understand.
For decades the medical profession has called into question the practice of chiropractic. Some have assumed the chiropractic adjustment had no value, while others referred to it as dangerous. Perhaps this is an opportunity to turn the tables and assist patients in an effort to question the validity of wholesale drug prescriptions without consideration of the potential harm to the patient.
Just a thought.
References
Continuing to impress the advertising and marketing world, The Foundation for Chiropractic Progress (F4CP) has again been recognized by industry organizations for its excellence in educating consumers on the benefits of chiropractic, this time through social media, newsletters, and demonstrating thought leadership by promoting holistic well-being.
Dr. Louis Sportelli received the Lee-Homewood Chiropractic Heritage Award during the annual conference of the Association for the History of Chiropractic (AHC). During his nearly 60-year career, Dr. Sportelli has embodied the spirit of the award, given to “living individuals who have made outstanding contributions to the chiropractic profession.”
Presently there is no consensus on the best treatment for Achilles tendon rupture; and its management is still controversial. The treatment options are conservative treatment and surgical repair. With either treatment, be it conservative or surgical, Achilles tendon tears necessitate prolonged recovery and rehabilitative management.
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