Estate Planning

The Beers List - definitely not your holiday shopping reminder

By Hull & Hull LLP

The administration of drug therapy in the elderly is a complex undertaking.  As a person ages, they undergo physiological changes; changes in body composition, gastrointestinal, liver and/or renal function that can alter both the therapeutic and toxic effects of drugs.  Created in 1991, and most recently updated in 2003, the Beers List includes drugs that 'are either ineffective in the elderly or put seniors at an unnecessarily high risk when safer alternatives are available' (CBC News, September 2007).  The list, compiled by a group of American experts led by Dr. Mark Beers, was created to determine which drugs should be used in nursing homes, since seniors are known to be particularly at risk for adverse side effects, including falls (see blog of November 28, 2008), depression, and even death.

Last year, the Canadian Institute for Health Information reported that the Beers List has resulted in a reduction in use of the listed drugs, as well as a reduction in the number of adverse side effects linked to these prescription medications.  It is, however, not all good news across the board.  According to CIHI, 25% of seniors are still receiving at least one drug on the Beers List.  Further, a 2005 CBC investigation found that in spite of making up only 13% of the population, seniors accounted for over 44% of all deaths reported to Health Canada's adverse drug reaction database between 1999 and 2003.

With families gathering this month for various holiday celebrations, it may be an appropriate opportunity to suggest a 'brown bag review' for mum or dad.  Just like the name suggests, a pharmacist or geriatrician can review all of mum's medications (both prescription and non-prescription, including herbal products) and check for correct dosage, frequency, duplication of drug therapy, discontinued products, and potential interactions.  It goes without saying that changes to a drug regimen should only ever take place under the direction of one's physician.

Note:  In 2007, CBC News 'Canadianized' the Beers List to reflect only those drugs available here in Canada, and also took the liberty of adding a number of benzodiazepines (medications that are prescribed for the treatment of anxiety and sleep disorders and have been found to increase the likelihood of a fall four-fold) that are available here, but not in the States.  Click here to access the modified version.

Stay tuned Thursday for a much lighter-hearted healthcare blog.

Jennifer Hartman, guest blogger

Full post as published by Toronto Estate Law Blog on December 09, 2008 (boomark / email).