Promoting safe medication use for adults 65 and older

Medication safety issues change as you get older. Here’s what you need to know.

Getting older comes with many changes, and those changes can affect your medicine cabinet.

The older you get, the more medication you’re likely to take. In fact, nearly half of adults age 65 and over take five or more medications each month.¹

Taking multiple medications on a regular basis (polypharmacy) increases the chance of harmful side effects, medication interactions, and other complications.

There are other challenges in prescribing for adults 65 and over

Because of the way the body absorbs, distributes, uses, and eliminates medication, adults age 65 and over respond to medications differently than younger people. For example, certain medications are more likely to cause falls as you age since they carry a greater risk of unsteadiness and fainting.

The effectiveness of medication can change as you get older, too. Depending on the medication, you may be more or less sensitive to it, requiring a dosage change.

There is also a lack of data when it comes to medication use and people in this age group. That’s because when drug manufacturers hold clinical trials for a new medication, they usually test it in people who aren’t taking many other medications. Also, they rarely test medications specifically in adults 65 and over, so there is little information about safety and treatment guidelines for adult patients in this age group.

Because of the challenges in prescribing for people over 65, one in every six older adults will have a harmful reaction to medication.²

What is the Beers Criteria and how is it used?

You may have heard of the Beers Criteria^® or the Beers list. Named for the doctor who developed it, the Beers Criteria is a list of potentially inappropriate medications for adults 65 and over.

Every three years, a panel of experts from the American Geriatrics Society evaluates studies and controlled clinical trials to see whether any recommendations need to be changed. Doctors, pharmacists, and other healthcare professionals use the list when prescribing medications to older patients.

If a medication is on the Beers list, that doesn’t automatically mean you should avoid it or that it’s dangerous for you. All medications can cause side effects, and you and your healthcare team have to weigh the risks and benefits of every medication, therapy, and procedure.

Taking a proactive approach to keeping you safe

At Express Scripts® Pharmacy, our pharmacists receive computer-generated alerts when a prescription may put a patient at risk. Alerts for adults age 65+ are based on the Beers list, maximum dose recommendations, and a number of other safety criteria. A pharmacist reviews the details of each alert and then reaches out to the patient or their doctor, if needed.

How can I ensure the medications I’m taking are safe for me?

We all have a part to play in medication safety. Talk to your pharmacist about any medications you’re prescribed, and make sure you know:

• Why you’re taking the medication.
• What side effects to look for.
• How to take the medication.
• Whether it will interact with any other medications you take.
• Whether it will affect another health condition you have.

Especially if you see more than one doctor, make a thorough list of all the prescription medications, over-the-counter drug products, dietary supplements, alternative medications, and vitamins you take. Bring this list with you to every appointment and share it with your pharmacist, too.

If you notice any new symptoms or possible side effects after you start a new medication, let your doctor and pharmacist know immediately. Writing things down in a medication journal is a great way to keep track of any changes in how you feel. Remember, our specially trained pharmacists at Express Scripts^® Pharmacy are available 24/7, so you can get the answers you need right when you need them.

1 AARP: Taking Multiple Medications? Beware of Side Effects (January 31, 2022): aarp.org.
2 American Geriatrics Society Health In Aging Foundation: Medications That Older Adults Should Avoid or Use With Caution (accessed January 2022): healthinaging.org.