Impacts of 2012 update to the AGS beers criteria on potentially inappropriate antipsychotic medication use among older adults

Abstract

Background: The 2012 update of the American Geriatric Society's (AGS) Beers Criteria addended a list of antipsychotics. This study examined whether this update was associated with potentially inappropriate antipsychotic medication (PIAM) use among the elderly. Methods: This study included multi-year (2006–2018) data from the Medical Expenditure Panel Survey (MEPS). Using a difference-in-differences model, the PIAM use patterns were examined among older adults (aged 65 and older) between pre and post 2012 using near-elderly (aged 50–64) as a control group. The study sample includes individuals aged 50 and older who had filled psychotropic medications during 2006–2018 (N = 20,422). Measures: The newly added antipsychotics in the 2012 Beers Criteria was used to identify PIAM. Outcomes include: 1) A binary indicator of whether the individual filled PIAM at least once during a given year; and 2) The total number of PIAM prescriptions filled by each individual during the same period of time. Results: After adjustment for confounding, the likelihood of using PIAMs declined significantly more in the elderly than in the near-elderly group (AOR=0.77, p-value=0.038). In pre and post comparisons, no significant reduction was found in the total number of PIAM prescription fills. Conclusions: The update of AGS Beers Criteria was associated with the reduction in the prevalence of PIAM use among older adults. However, no reduction in the total number of PIAM prescription fills was found once the elderly initiated a PIAM treatment. This suggests a need for clinical and policy efforts to control overall PIAM consumption particularly among the elderly PIAM users.

Keywords

• Inadequate prescription
• Older people
• Potentially inappropriate medication list
• Psychotherapeutic drugs