Aging inappropriate use of drug as the two

Aging is linked with many physiological changes in human body e.g. change in the composition of body, decrease in the functions of kidney and liver. These changes altered the pharmacokinetic and pharmacodynamic properties of older adults which in turn increase the chances of drug related problems such as drug drug interactions, adverse drug events and drug disease interaction.(Obreli-Neto, Nobili et al. 2012). A serious and growing public health problem is adverse drug reaction in this population. Polypharmacy, presence of many comorbidities and socioeconomic status constitute risk factors for the development of adverse drug reactions in older population.(Fick, Mion et al. 2008, Pasina, Brucato et al. 2014).
Another study highlights poly pharmacy and inappropriate use of drug as the two basic factors of the occurrence of adverse drug reactions.(Atkin, Veitch et al. 1999, Onder, Van Der Cammen et al. 2013).Polypharmacy is very common among older population due to multimoirbidity, it is also linked with inappropriate use of dug and ultimately ADRs and thus it affects the quality of life and causes morbidity and mortality in elderly.(Herr, Robine et al. 2015, Saastamoinen and Verho 2015)
Inappropriate use of medicines in elderly is one of the challenges of the public health domain and places a significant burden on the healthcare system.(Van Der Hooft, Jong et al. 2005).Potentially inappropriate drug for older adultd can be defined as the drug whose risks are higher than their ultimate benefits especially when there is more safer and better drug is available for the same condition. (Beers 1997) (Corsonello, Pranno et al. 2009)
To reduce the drug related problems in this high risk population first step is to find out the potentially inappropriate medications(PIMs). In order to address this important issue experts has deviced many screening tools for the identification of the potentially inappropriate medication,one of the important tool is Beers criteria. Mark H. Beers, MD, a geriatrician, created the Beers Criteria in 1991 (Beers, Ouslander et al. 1991)which were later updated in 1997, 2003(Fick, Cooper et al. 2003)., 2012 (Campanelli 2012)and 2015(Panel, Fick et al. 2015).. The AGS Beers Criteria for potentially inappropriate medications (PIM) are one of the most frequently consulted source about the safety of prescribing medications for older adults. Beers criteria are widely used in geriatric clinical care, education and in research and development of quality indicators. In 2003, AGS made a commitment to update the criteria regularly, so in 2012, first update of the criteria were released since 2003.on the basis of evidence based recommendation as compared to the previous versions, major reformations were done in 2012 criteria(Campanelli 2012). In 2015s citeria changes were not as extensive as in previous updates, but only two following lists were added a)drug drug interaction b)drugs for which dose adjustment is required based on individuals kidney function(Panel, Fick et al. 2015).beers criteria were used in many settings(outpatient,home care and hospital settings) all over the world to find out the PIMs. With the increasing use of the Beers criteria as a quality-of-care measure, a need exists to strengthen the predictive validity of the Beers criteria in all health care settings. (Jano and Aparasu 2007)


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