Beers criteria-based review of medication appropriateness in British Columbia seniors living in residential care

A study was conducted to explore the prevalence and predictors of inappropriate prescribing, as defined by the 2002 Beers criteria, in a sample of nursing home residents in British Columbia, Canada (n=,449). Medication-related data were extracted from residents' medication review letters. The overall prevalence of inappropriate prescribing was 29.4 percent. The prevalence rates for the three sub-types of inappropriate prescribing, namely unconditionally inappropriate prescribing, inappropriate drugdisease combinations, and inappropriate doses or durations, were 16.9, 12.4, and 5.1 percent, respectively. The likelihood of inappropriate prescribing was increased with the total number of prescription medications and the number of prescribing physicians. The single most commonly prescribed inappropriate medication was anticholinergics, for residents with cognitive impairment. Clinicians need to be extra vigilant to distinguish between the central nervous system effects of anticholinergic medications and the effects of the underlying disease.