presented by Kenneth L. Miller
Annually in the US, there are about 400,000 preventable adverse drug events that account for $3.5 billion in extra costs. Physical therapists are key members of the interdisciplinary health care team with the knowledge and skills to monitor patients' medication for intended effects, side effects and adverse drug events in the geriatric population. Using the 2015 Updated Beers Criteria - List of Potentially Inappropriate Medications for Older Adults (published by the American Geriatrics Society), physical therapists have the necessary tools to address medication safety with their patients to reduce the risk of adverse drug events and associated re-hospitalizations which are considered preventable. Many older adults believe that over the counter medications are "safe" for them to use, not knowing the dangers these medications pose. The Beers Criteria is a useful tool for therapists to integrate into practice to determine which prescription and over the counter medications are potentially inappropriate and/or the effects medications may have on physical performance and functional ability.
Dr. Kenneth Miller has been an educator, physical therapist, and consultant for the home health industry for more than 20 years and serves as a guest lecturer, adjunct teaching assistant, and adjunct professor in the DPT program at Touro College in Bay Shore, New York. He has presented at the Combined Sections Meeting of the American Physical Therapy Association (APTA), the Educational and Leadership Conference of the American Council of Academic Physical Therapy and Education Section of the APTA, and the Annual Conference of the National Association for Home Care and Hospice on a variety of topics, including objective testing, professionalism, interdisciplinary team modeling, osteoporosis, differential diagnosis of dizziness, documentation, patient engagement, student program development, and home health regulations. He serves as chair of the Practice Committee of the Home Health Section (HHS) of the APTA. As the chair, he led the development of the "Providing Physical Therapy" section in the third edition of the home handbook, the Home Health Student Program Roadmap & Toolkit, and The Home Health Section Toolbox of Standardized Tests & Measures. He is a member of the editorial boards of the GeriNotes publication and of the Journal of Novel Physiotherapy and Physical Medicine, and is a manuscript reviewer for the Journal of Geriatric Physical Therapy and the Journal of Primary Care. Dr. Miller has authored numerous articles for the Journal of Geriatric Physical Therapy, GeriNotes, and the HHS newsletter, The Quarterly Report.
This chapter will explore how pharmacokinetic and pharmacodynamics changes occur with aging in clinical terms with a focus on the intended effects, unintended effects and potential risks older persons face. This chapter also will provide definitions of commonly used terms regarding pharmacology.
This chapter will introduce the Updated BEERS Criteria tool and demonstrate how to use it to improve medication safety in the older adult. The tool lists potentially inappropriate medications by class and explains the adverse effects seen with the medications.
This chapter will use case scenarios to highlight common medication misconceptions regarding medication safety with over the counter and commonly prescribed medications. Example medication review will be provided.
This chapter will explain medication side effects seen with the older adult and provide tools to differentiate patient signs and symptoms attributed to medication side effects and other causes.