Prevalence of Beers Criteria Potentially Inappropriate Medication Use and Associated Factors among Three US Studies

BACKGROUND: The aim of this study was to assess the prevalence of potentially inappropriate medication (PIM) use among adults ≥ 65 years, overall and for population subgroups, and factors associated with prevalent PIM use. METHODS: Participant and medications data from the Atherosclerosis Risk in Communities (ARIC), Multi-ethnic Study of Atherosclerosis (MESA), and Action for Health in Diabetes (Look AHEAD) were used. The total number of individuals contributing to analysis was 9439 for ARIC, 5223 for MESA, and 3771 for Look AHEAD. Participants' medication data were collected at study exams with medication inventories. Prevalence of any PIM use (yes/no), total number of PIMs used, and the major drug classes of PIMs used within a cohort were identified using Beers Criteria closest to the time of study exam (1997 onward) for all participants aged 65 years or older. Multivariable adjusted logistic regression was used to assess demographic and clinical factors associated with prevalence of any Beers Criteria PIM at the first exam after turning 65 years of age, separately for each cohort. RESULTS: The prevalence of PIM use at the first exam at ≥ 65 years was 67% in ARIC, 51% in MESA, and 70% in Look AHEAD. The most prevalently used PIM classes across cohorts were non-aspirin pain medications, proton-pump inhibitors, and sulfonylureas. Higher body mass index and diabetes were consistently associated with greater odds of PIM use across cohorts. CONCLUSIONS: Use of potentially inappropriate prescription and nonprescription medications was highly prevalent across three diverse cohorts and highlights the need for clinicians and pharmacists to review patient medication lists and optimize management of medications.