Medications for Older Persons. Recommendations, Harms, Evidence

Table of Contents

Section 1. Recommendations for medications of older persons
1. A summary of medications that most benefit older patients: for clinicians, patients, their families, policy makers and health ministries
2. STOPP and American Geriatrics Society “potentially inappropriate medications" (PIMs) and START ”potential prescribing omissions” (PPOs)
3. The Calgary study of 295,706 admissions of older persons to four acute care hospitals 2013-2021
4. Adverse drug interactions in the Veterans Affairs Adverse Drug Event Reporting System
5. Pharmacokinetics and pharmacodynamics in older persons
6. Methods to identify adverse drug interactions and effects
7. How personalized medicine has changed senior patient outcomes at the Mayo Clinic and other centers

Section 2. Older persons alcohol consumption, self-medication, and medication list accuracy
8. Older persons alcohol consumption
9. Self-medication and over the counter medications by older persons
10. The accuracy of recording medication lists, transferring lists between community practitioners and medical institutions, and the potential effects on the accuracy of assessing PIMs, PPOs and adverse medication events

Section 3. Cardiovascular medications
11. Medications for hypertension
12. Medications for heart failure
13. Medications for arrhythmias
14. Medications for diuresis
15. Medications for coagulation

Section 4. Central Nervous System medications
16. Medications for depression
17. Medications for anxiety
18. Medications for insomnia
19. Neuroleptic/antipsychotic medications
20. Avoiding medications with risks of delirium
21. Avoiding medications that augment dementia

Section 5. Renal medication
22. Prescribing to reduce risks of renal insufficiency and failure

Section 6. Gastrointestinal medications
23. Prescribing to reduce the risks of peptic ulcer disease, gastritis, and esophagitis and treat if present
24. Prescribing to reduce the risks of constipation or diarrhea

???????Section 7. Musculoskeletal medications
25. Medications for arthritis
26. Medications for osteoporosis

Section 8. Respiratory medications
27. Medications for COPD

Section 9. Endocrine medications
28. Medications for diabetes

Section 10. Pain medications
29. Non-opioid analgesics and opioids for seniors

Section 11. Changing prescribing to prevent falls
30. Prescribing to prevent falls

Authors

Roger Thomas Emeritus Professor, University of Calgary, Canada. Roger E. Thomas, MD, PhD, CCFP, FCFP, MRCGP, holds a BA Honors in Economics from Cambridge, PhD in Sociology from Yale, an MD from McMaster, and practiced as a rural physician 1979 in Newfoundland. Through 1980 to 1983, Dr. Thomas performed Medical Missionary work in Malawi. Through his career, Dr. Thomas has held faculty positions at East Carolina University, Toronto, Ottawa, Newfoundland, and currently is an Emeritus Professor of Family Medicine at the University of Calgary. He has 187 peer-reviewed publications and 108 abstracts on such topics as adverse medication events on seniors' rehospitalization and death, prescribing for seniors using genomic data, evidence-based methods of deprescribing to reduce readmissions and death, total costs of seniors' care and options to finance most needed care.