This study is an important update of previously established criteria that have been widely used and cited. The application of the Beers criteria and other tools for identifying potentially inappropriate medication use will continue to enable providers to plan interventions for decreasing both drug-related costs and overall costs and thus minimize drug-related problems.

The purpose of this study was to examine the prevalence of potentially inappropriate medication use (PIMs) among community-dwelling older adults and the association between PIMs and health care outcomes. Participants were 17,971 individuals age 65 years and older. PIM use was defined by the Beers criteria. Drug-related problems (DRPs) were defined using ICD-9 codes. Forty percent of the 17,971 individuals filled at least 1 PIM prescription, and 13% filled 2 or more PIM prescriptions. Overall DRP prevalence among those with at least 1 PIM prescription was 14.3% compared to 4.7% in the non-PIM group (p < .001). In conclusion, preventing PIM use may be important for decreasing medication-related problems, which are increasingly being recognized as requiring an integrated interdisciplinary approach. Keywordsmedications; healthcare costs; geriatrics; adverse drug events Drug-related problems (DRPs) are prevalent in the older adult population and pose a major patient safety concern. DRPs arise because of the increasing number of medications required by this age group, fragmented systems of care, pre-existing health conditions, and the pharmacokinetic and pharmacodynamic changes that occur with aging (Bigos, Bies, & Pollock, 2006;Cusack, 2004;Gurwitz, 2004;Hajjar et al., 2003;Turnheim, 2004Turnheim, , 2005. Avoiding use of high-risk drugs is an important strategy in reducing DRPs. The purpose of this study was to examine both the prevalence of potentially inappropriate medication (PIMs) use among community-dwelling older adults and the association between PIMs and health care outcomes.One method promoted to identify high-risk medications is the use of an explicit list of PIMs. PIMs were first devised and publicized by Beers et al. for nursing home residents and subsequently expanded to include older adults in all settings (Beers, 1997). PIMs are medications identified through expert panel review as having risks that outweigh benefits (Beers et al., 1991). Since the early 1990s, the prevalence of PIMs has been examined in a (Lau, Kasper, Potter, & Lyles, 2004), outpatient (Aparasu & Sitzman, 1999Curtis et al., 2004), acute care (Onder et al., 2005), and community settings (Zhan et al., 2001). For research purposes, use of explicit criteria is generally preferred over the use of implicit criteria applied by expert reviewers.The clinical validity of using a list of medications based on expert panel review and explicit criteria has been questioned as being overly simplistic and not including all the common drugs causing problems in older adults (Crownover & Unwin, 2005;Shorr, 2004). Moreover, despite the numerous reports of the prevalence of PIMs, only a few investigators (Fu, Liu, & Christensen, 2004;Thapa, Gideon, Cost, Milam, & Ray, 1998) have examined whether PIMs are associated with adverse clinical outcomes. Therefore, we investigated the outcomes associated with PIM use in a population of community-dwelling older adults.The Beers criteria have been revised recently; hence, the current prevalence of PIMs in...

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LVH occurs commonly in children with hypertension and is associated with an increased BMI. LVH may be more prevalent in Hispanic children than in other ethnic groups. Prevention and treatment of obesity is important in reducing the cardiovascular risk for children with hypertension. Further evaluation of the frequency of LVH in multiethnic populations is needed.