CEimpact Podcast

Is Beers Criteria Still Relevant to Pharmacy Practice?

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This episode discusses the relevancy of the Beers Criteria in clinical practice, examining how recent changes impact medication safety and prescribing practices for older adults. Learn strategies for effective deprescribing and discover best practices for applying these criteria to improve patient outcomes. This essential episode equips healthcare professionals with the knowledge needed to navigate complex medication regimens and advocate for safer prescribing practices.

HOST
Joshua Davis Kinsey, PharmD
VP, Education
CEimpact

GUEST
Kristin Meyer, PharmD, BCGP, FASCP
Professor of Pharmacy Practice
Drake University College of Pharmacy and Health Sciences

REFERENCE
American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults

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CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Discuss recent updates to the Beers Criteria and their impact on medication safety for older adults.
2. Describe evidence-based strategies to implement the Beers Criteria and manage complex medication regimens in clinical practice.

0.05 CEU/0.5 Hr
UAN: 0107-0000-24-282-H01-P
Initial release date: 10/28/2024
Expiration date: 10/28/2025
Additional CPE details can be found here.

Looking for more? Check out our course on deprescribing in older adults:
Less is More: A Patient-Centered Approach to Deprescribing for Older Adults
1 hour  |  On Demand
Polypharmacy in older adults leads to significant health risks and increased costs. Learn how to effectively engage in deprescribing, using patient-centered and evidence-based approaches to reduce unnecessary medications. Enroll in this course to enhance your skills in facilitating safer medication practices, become a leader in deprescribing, and improve patient outcomes!

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Speaker 1:

Hey, CE Plan members From CE Impact, this is Game Changers. I'm Jen Moulton, President and Founder of CE Impact. If you're an avid listener, you know I've served as your host for quite some time now, and the time has come to pass the reins to one of our very capable and gifted pharmacists, Josh Kinsey. Dr Kinsey has been with CE Impact for more than three years now and is the mastermind behind our course content and curriculum.

Speaker 1:

I'm so excited he's agreed to host the podcast because I think you are all going to learn so much from him and from all of our guests. But before I pass the torch to Josh, I wanted to get in a shameless plug for subscribing to Pharmacist by Design if you don't already. You can get CE for this podcast plus so much more for less than $10 a month. You're already listening, so there's no reason not to claim CE credit for learning. Check out the link in the show notes or go to ceimpactcom to enroll. Okay, back to the episode. It's been a pleasure to serve as your host until today, and now I'm honored to pass the mic to Josh. Take it away, my friend.

Speaker 3:

Hey CE Impact subscribers, Welcome to the Game Changers Clinical Conversations podcast. I'm your host, josh Kinsey, and as always, I'm excited about our conversation today. With an aging population and increasing medication use, understanding the BEERS criteria is more important than ever for preventing adverse drug events in older adults. In this episode, we're going to explore recent updates to the BEERS criteria, discuss its role in guiding safer prescribing practices and share practical strategies for effective deprescribing to enhance patient care and safety. It's so great to have Kristen Meyer as my guest for this episode. Welcome, kristen. Thanks for joining us today.

Speaker 2:

Thanks, josh, glad to be here.

Speaker 3:

Before we jump into the meat of our conversation on Beers Criteria and deprescribing, kristen, why don't you take just a minute or two to tell us a little bit about yourself, your current role and practice site? And our learners always love to hear. Why are you so passionate about today's topic? So tell us what it is that draws you to Beers Criteria and deprescribing for our geriatric patients.

Speaker 2:

Sure. So for a little over two decades I have been with Drake University's College of Pharmacy and Health Sciences. I am a professor of pharmacy practice, which means that in addition to my classroom teaching duties, I get to be a real pharmacist, as I joke about with my colleagues sometimes and bring students along for the ride. As a board-certified geriatric pharmacist, I work with seniors and doctors and nurses in lots of places where seniors live assisted living, nursing homes and just everywhere in between. I love it. I love helping students find their passion, whether that's geriatrics or not, but I love helping turn them on to an area of pharmacy that they might not have known too much about.

Speaker 3:

Yeah, I can agree with that. I felt like peds and geriatrics are, you know, the opposite ends of the spectrum, but yet you know not as much as placed on the emphasis on learning for either of those special populations during school. So I mean, we learn obviously about them and different things, but there's so much more if you really start digging into those specific areas. So that's great that you're trying to enlighten some of the students on the opportunities that they may not know existed, so that's awesome. Well, thanks again for sharing about yourself and for joining me today. So I am ready for us to jump into the meat of the conversation. Let's just start with, if you can share, just a little bit of historical context. I'm sure most of our learners have heard of Beer's Criteria, but for those that haven't, just a quick review of what it is and maybe why it came to be and why we follow Beer's Criteria with so many different things for our aging population.

Speaker 2:

Sure, yeah, beer's Criter criteria has been around for a long time and I would imagine that most people have heard of it in some way, shape or form. The most recent update that we'll be talking about today is the 2023 update, but this began many, many, many years ago. Dr Mark Beers very passionate in the area of geriatric care and research, and he was doing research in nursing homes in the 80s that really uncovered the problem of inappropriate medication use in older adults living in nursing homes, and so then he carried that passion on and published his first, what we call the Bears Criteria in 91. I think maybe my first exposure to it was 97. I would have been in pharmacy school at the time. And so this publication is updated periodically.

Speaker 2:

It's not any sort of regular cadence, but it is multidisciplinary. It has evolved to be evidence-based. The American Geriatric Society has kind of taken over ownership of that almost what's becoming a living document. And again, the most recent publication was in 2023. And again, the most recent publication was in 2023. And we'll discuss the changes here in a minute. But it really is evolving to not just focus on what not to do, what's inappropriate, the do not use, but then how to move towards more appropriate medication use and how to move away from some of these less appropriate meds.

Speaker 3:

Yeah, that's great. It's a great call to talk about how it is kind of morphing, because I remember I wasn't too far behind you in school and that would have been my first introduction to various criteria. Almost Well, it would have been over 20 years ago now when I would have been first introduced. I do remember it being a do not list. You know like it was basically do not use this, do not use these, get rid of them, like don't prescribe them. If you see them, try to get rid of them. I love the idea that it's also, you know, becoming kind of a guidance for appropriate use and proper use and things like that. So that's really good to know. Great. So let's talk a little bit about you've kind of set it up, so let's go ahead and discuss a few of those changes. I guess those changes were early in 2023, right?

Speaker 2:

I think that they- Right, we waited forever, what it seemed, for that publication to come out, and it was early 2023.

Speaker 3:

Okay, so we're looking at about 15 or so months ago since the last update. So, okay, let's talk a little bit about, then, some of those key changes that you saw in the latest iteration.

Speaker 2:

Sure. So they outline their changes and I guess overall, if I'm just looking, I think that these changes really are reflective of their focus on evidence-based medicine and the focus on you know. The more we learn, the better information we have, the better we can do for our patients. One example would be aspirin. We're constantly learning more about the risks and the benefits of aspirin for older adults, and so their most recent recommendation really underscored the idea of increased bleeding risk as people age and the idea that we need to focus on primary versus secondary prevention.

Speaker 2:

Why is this person taking aspirin? Is it just because someone thought they should for their health primary prevention or is it secondary prevention? Maybe they've had a heart attack or a stroke and that would be appropriate medication therapy for that patient at that time. So it really does focus on risk versus benefit and just underscores the idea that for primary prevention, we really need to think about getting rid of or not doing aspirin for these older adults or consider deprescribing it when we can't find a clear reason why they have used for that person, and it comes down to bleeding risk. And in that same vein, the more we learn about new well, they're not so new anymore oral anticoagulants the Apixaban, the Rivaroxaban they've changed some recommendations for those agents and so, when we're thinking about just all the antiplatelets and anticoagulants in general, there's evolving information about how we might use those for older folks. There's evolving information about how we might use those for older folks, and so there's information in there about those agents and their preference over warfarin for traditional anticoagulation.

Speaker 3:

Okay, a quick question. So you mentioned earlier that the document is somewhat becoming a living document, is somewhat becoming a living document, and how I heard that was that changes occur even when the official updates aren't occurring. But maybe that's not what you meant. The question is about the aspirin, because it does change so often. I feel like every time I open up a newsletter on it, it's like oh, now you're not supposed to take it. Oh, now you should take double the dose. You know it's like changes all the time. So I feel like how do you know if you're using the most recent evidence-based guidance on that from Beers?

Speaker 2:

Yeah, yeah, and I probably misspoke when I said living document, but having seen so many iterations of it, you can see that they are focusing on the most recent evidence available, the best evidence available at the time, to make these updates, and hopefully we'll see the updates with improved frequency so that we can have the most and up-to-date information when we are making our recommendations. So I think that what you said about you know referencing the material and knowing the why is incredibly important. I would underscore that for the readers today. Like, not just this medication is on the beers list. Anybody can do that. You as a pharmacist. You're the medication expert and you need to be able to explain to patients and providers why this medication is on the beers list, what the particular risks would be for that older person and also then alternatives.

Speaker 3:

Yeah, and that's key, and that's I want to get into that later. That's going to open up a whole other thing as well, because you know it's important for us as pharmacists to not just say, oh, you need to stop this, but to give the alternative, to have thought it through, to determine what the plan is for the patient, so that the care continues so yeah, let's put a pin in that, because I want to come back. Continues. So yeah, let's put a pin in that, because I want to come back, so yeah. So, other than aspirin, what were some of the other key changes that we saw in the 2023 update?

Speaker 2:

Right. So a couple of other things changes. Maybe some strengthened language about the risks of long-term use of PPIs. That's been something that we've long known, but I can speak from experience that it's really difficult to get folks off of PPIs. So just strengthen language and just increases the importance of trying to deprescribe those agents. And then just some other minor changes throughout the document. There are some very helpful tables in these documents about drug interactions, drug disease interactions, in addition to the strict like inappropriate medications, like in all older adults. And then there's also a table of medications that we should focus on when persons have decreased renal function, and that's a lot of older folks.

Speaker 2:

So, yeah, just other minor changes throughout, but those were some of the big drug changes that really have informed my practice over the last year or so.

Speaker 3:

Yeah, that's great and remind me the 2023 was. Was it the first in about a decade? Am I correct on that?

Speaker 2:

My, I think, 2015. 15, okay, so almost yeah, yeah okay. I don't think there had been one since 2015. So we'd been waiting a while, yeah, okay, and it was every oh, three, well, five to seven years before that, I suppose.

Speaker 3:

Okay, okay, so this one may be a little bit longer than than previously. Okay, good to know, and I do feel like too. You know it's been again. Because of the areas that I've been practicing in, I haven't been regularly looking at beer's criteria, but I feel as though you know you speak about there's charts and there's lots of helpful graphs and things like that. I and maybe I'm just misremembering from 20 years ago, but I remember it just almost being like a list, like I don't necessarily remember there being all of those helpful different charts and things. Maybe I just didn't dig into it deeper. But is that kind of a new thing as well, or have we always kind of seen more assistance than just a chart? I guess.

Speaker 2:

Yeah, I believe it has improved over time and it's an easy read. It's not very text heavy. It really does focus on the charts and you can dig into those and find where the drugs are, the rationale behind where they are. They've got strength of evidence in this publication and so it's it's a great tool of reference. This is not something anyone can memorize I don't even expect my students to memorize the whole thing, maybe, Maybe certain aspects but it's a great tool and, if I might back up, you know, I really want to emphasize that because if you are practicing with in any area except for PEDS, this is an important tool to be aware of and to utilize and to reference, because it's been adopted by CMS into long-term care regs and there are references. If you're doing MTM, there are references to inappropriate medications in that realm as well, so it really does touch so many areas of pharmacy practice.

Speaker 3:

That's good to know. So, again, for our listeners, this is not an episode just for those that are in long-term care. This touches a lot of different practice areas, so that's great, okay. So along those lines, now that we've talked about Bayer's criteria, its evolution, know, its impact on on practice and how it's kind of evolved into, like you said, very, very strong, evidence-based criteria for us to follow and tool for us to use, I want us to get into de-prescribing, because the whole point of beer's criteria is to point out those medications that are inappropriately used and, as mentioned, we need a path for a solution, like we can't just say get rid of this. We have to either deprescribe and show an alternative or deprescribe with a reason. So I'd love for us to talk a little bit about deprescribing. What do you see as the role of the pharmacist in that process?

Speaker 2:

You're right. We can't not just rely on this is an inappropriate medication, but the role of the pharmacist is to use that medication knowledge to offer more appropriate solutions. So this is the area which I am most passionate about. The pharmacist is the only person on the team, on the healthcare team, that has this unique knowledge of drugs, how they work in the body, how they work in the older adult's body and how we can, you know, prevent or minimize adverse reactions. So I think the first thing to do, you know, obviously recognizing inappropriate medications, but the next thing is understanding the why. Not only like first.

Speaker 2:

Why might this medication bid have have been prescribed in the first place? I'd like to give somebody the benefit of the doubt for, you know, putting that medication on the regimen in the first place. But I also tell my providers and my patients and their families what you needed 20 years ago, 40 years ago, isn't always what you're going to need. So it does bear us kind of taking a look at the regimen again and reevaluating and then asking ourselves what's most important today and what matters most to the patient. I always tell my students the most important problem you're going to solve today is whatever the patient says their problem is, and so we really. If we keep the patient at the center, then we can be very successful in improving medication safety.

Speaker 2:

If I tell a doctor that I would like him to consider decreasing the dose of this medication because Mrs Smith slept through lunch today, I'm focusing on that patient. I'm focusing on the adverse effect of the drug and what it meant, you know, for her day. There's not much argument about that. You know we can. We can argue about doses and you know particular drugs in a class or whatever. But if we all focus on what's best for the patient, there's not a lot of argument there. If we all focus on what's best for the patient there's not a lot of argument there and you're going to have a great impact for patients and their families and health systems. You know it's all about quality.

Speaker 3:

Absolutely.

Speaker 2:

We want to improve quality in a number of different areas, and so focus on the patient, and the rest of the good stuff follows.

Speaker 3:

Yeah and Kristen, I love how you, like you said you, focus on the patient and the rest of the good stuff follows. Yeah and Kristen, I love how you, like you said you, you focus on the patient. So, instead of just saying I want to decrease this dose to prevent, you know, sleep or to prevent drowsiness, you made it about the patient, like you, were very specific with the example of I want to decrease this dose so that she doesn't sleep through lunch again, you know. So, again, I think that's a great call out to be very specific, not just to have done your research and know the plan and to potentially submit an alternative, which is to decrease the dose or to try another medication or whatever, but to give that clarifying reason about the patient, because I think that makes it so much more personal and that's really, like you said, the overall goal is to ensure that we're improving that patient's quality of life and not just doing our due diligence of deprescribing Like you know we're. We're doing it because the patient is going to be impacted. So that's a really great call out. I love that.

Speaker 3:

So, with the de-prescribing, how it can be a daunting task, if you're you know, let's be honest, if you know, pharmacists right now are juggling a lot of balls, spinning a lot of plates where. What are some practical tips? Like, how do you start? What do you look for? Are there cert? Are there like the top 10? Always offenders, you know? Like what meds should we keep our spotty senses out for? Like, what should we be looking for? Just as kind of to get our feet wet in the process.

Speaker 2:

Sure, the first thing that I want to kind of go back and remind people is that BEERS is intended for older adults everywhere except end of life situations, hospice situations. Certainly there are some reasons why we would use and not use medications, and that is a whole separate realm. But beers applies to all older adults in some way or another. And if I'm prioritizing, I would pick on the anticholinergic medications first. If I was choosing a class of drugs, those that are anticholinergic by mechanism or those that have anticholinergic side effects, those are going to be extremely dangerous for older folks. In the short term we're talking dry mouth, urinary retention, constipation, but in the long term we're talking cognitive decline. So if I'm picking a class of medications, that's what I'm going to pick on Now you know, otherwise I'd go back to.

Speaker 2:

The pharmacist has a unique way of reviewing a patient. In my observation Some of our colleagues in you know, in medicine and nursing they might be looking at the patient from kind of a disease state focus. I'm looking at their diabetes, at their hypertension or whatever. I, as a pharmacist, the very first thing I look at is the medication regimen.

Speaker 2:

And then I look at the problems and the next thing I think is is any of these problems that this patient is experiencing potentially caused by a medication they're taking? So that's my second focus. Is there anything that they're experiencing that if I got rid of a certain medication I might fix that problem? So that mindset is unique to the pharmacist and then it also does open up and just really facilitate this idea of deprescribing, of de-prescribing. So again, when you're looking at getting rid of meds, you know we keep the patient focus and then apply that mantra of geriatrics sort of in a reverse fashion.

Speaker 2:

But the start low, go slow applies to de-prescribing as well.

Speaker 2:

You know, I might be looking at not eliminating a med but maybe decreasing the dose and maybe, you know, depending on the medication and the reason why, we might be doing it like not more than half, but sometimes just a tiny bit, because some of the resistance to deprescribing amongst patients and providers is maybe they had a, maybe the patient experienced return of symptoms or withdrawal side effects, and so if we can just take baby steps and the more quote, unquote wins that you have, the better you know, the more you can do for a patient or with a provider.

Speaker 2:

And then the benefits are numerous, you know, not just decreased cost, decreased number of meds, but we're talking about some of these particularly high-risk meds. We're talking about decreased injuries, decreased hospitalizations, decreased changes in level of care. You know, if I talk to someone in assisted living and I said I'm really concerned about your use of this benzodiazepine medication here's some of the things that I'm concerned about and I list some side effects and I said I'd really hate for you to have this problem and have to change your level of care or not be able to live here sort of on your own anymore. Wow, that's a great motivator.

Speaker 3:

Sure, yeah for sure, definitely. And also, you know, as you mentioned, you know getting those wins here and there. It also builds confidence for the pharmacist who is, you know, doing the deepers, are trying to initiate the deep prescribing. You know, getting a small win. It's like, okay, the doctor agreed with me, that, you know, the provider, the prescriber agreed with me, so next time when I call there, they're going to listen, as again, and then we're going to be able to go deeper each time and, and you know, build that relationship and that trust. Okay, that's great.

Speaker 2:

So yeah, not only the farm, the pharmacist confidence in their own abilities, but the rest of the team's confidence in the pharmacist You're exactly right.

Speaker 3:

Yep, You're exactly right, it goes both ways, yeah for sure. So I heard anticholinergics. Obviously you you mentioned previously and I don't want to put words in your mouth, but I would assume another one on that lookout on your radar would be long-term PPI use potentially, as that's one that you mentioned, and then potentially aspirin, since that's one that kind of got a lot of traction in the recent update, just to kind of again prove do they need to be on it, Try to figure out what it is, and does the risk, you know, outweigh the benefit, or the benefit outweigh the risk? And then, so what else? Maybe, maybe one or two others that you kind of keep your, your, your tentacles out for?

Speaker 2:

Yeah, as long as we're kind of going over my pet peeves and inappropriate medication use. Psychotropics I'm just going to broadly call out psychotropics, whether they be antipsychotics, antidepressants, anxiolytics I alluded to that oh, and we can't forget sedative hypnotics. There is no safe sleep agent for older people. I said that really slow Cause I want everybody to hear that.

Speaker 3:

Um say it again for those in the back Right.

Speaker 2:

No safe sleep agent for older folks. We need to focus on non-drug measures for all of those things. I don't pick on antidepressants as much as some of the others but honestly, if we need to talk about cognitive behavioral therapy, sleep hygiene and realistic expectations behavioral therapy, sleep hygiene and realistic expectations, and you know, and I think there are appropriate uses of all of those medications for all kinds of folks. But again, then periodic reevaluation to make sure that we are using the minimum effective dose, all of those medications. Another big topic that I am very passionate about is falls and all of those medications. Another big topic that I am very passionate about is falls, and all of those medications can greatly increase a person's fall risk, even antidepressants. It's in beers and so you can find the evidence behind the recommendation. So that's a big area for me. And again, just constant evaluation, re-evaluation.

Speaker 3:

Yeah, yeah, that's great, that's really great. So let's talk a little bit about we know the history of VIRS criteria now and kind of the rationale for it. We've talked a little bit about the pharmacist role in deprescribing and why it's important for us as pharmacists to take on that responsibility and to really advocate for the patient. So let's talk a little bit about what impact is this going to have? So clearly, we know it's going to impact the patient, but what other impact is ongoing? And you've touched on some of this before, but just kind of reiterate, you know, why do we want to deprescribe? What's the overall goal?

Speaker 2:

Right. So I guess kind of three areas come to mind. First and foremost, it's easily proven that you know, focusing on these inappropriate medications, trying to deprescribe this, is definitely going to result in decreased medication use and decreased costs, which can improve adherence. I think some of the research is lacking in the area of proof of other benefits. When we talk about injuries and hospitalizations and some of the other quality things that matter to us, I think that maybe it's not that it doesn't exist, but it's kind of hard to pinpoint that quality conversation is always difficult when we're talking about maybe two different buckets.

Speaker 2:

You're talking about medications over here and the medical side over here. But certainly you know, I think there are benefits and and again, keeping patient at the center. The other thing you know is, from the quality assurance standpoint I mentioned before, there are quality measures tied to these inappropriate medications which come from beer. Cms adopted these and so they're looking at these, and so if you want to promote quality in your healthcare system, you're going to want to make yourself familiar with these medications and their use and try to design systems and education that avoids use of these medications and folks.

Speaker 3:

Yeah, yeah. So not just you know, so, not just you know, not that it should be focused solely on the almighty dollar, but there is a monetary reason to do this. I mean because, again, it decreases hospitalization, re-hospitalization and it overall improves the bottom line for health right For healthcare.

Speaker 2:

So well, absolutely. I mean just a really simple example. You know you've got a patient in the hospital for an older patient, for you know various reasons and maybe they are delirious and maybe they are prescribed an antipsychotic and it's appropriate use in that moment for that patient because it might help them stay safe where they're at moment for that patient, because it might help them stay safe where they're at. But if that doesn't get scrutinized, when they move over to the nursing home side, and maybe they weren't taking that medication before hospitalization but they continue to take it after hospitalization and they go over the nursing side, nursing home side, the medication continues, the medication builds up, the side effects build up, they have a fall, break their hip, they're right back to the hospital and that's bad for everyone it's bad for the patient, it's bad for the nursing home, it's bad for the health system. If those patients back, and that is an all too common example.

Speaker 3:

Yeah, and and you, you've now increased the risk of infection because they're back in the hospital for us with a and and you, you've now increased the risk of infection because they're back in the hospital for us with a surgery and you know, a wound, and and so you've opened the door for even additional complications.

Speaker 2:

It's a slippery slope, no pun intended.

Speaker 3:

Yeah, exactly, exactly, yeah, for sure. Yeah, that's. I mean, that's such a great example because something as simple as you know, just to someone at some point just accepted the fact that they're now on this medication, they didn't question and say, was that just given in the hospital? Do they really need to stay on this? Was it just a one time thing? Or you know and I remember seeing that many times when I was in community practice when you would see someone come out and they'd been on a 14-day supply and then you would call the new not the new, but their PCP, who was now back taking care of them, and you'd say, hey, they've been on this for 14 days, do you want to continue? And sometimes they would just be like, oh well, they put them on it, then keep them on it.

Speaker 3:

And again, that it's that miscommunication of did we dig deeper? Do we really need to be on this? Was it just a, an interim type thing? Um, because you're right, it's a. It's just such a slippery slope because so many things can can go wrong after that. So so, yeah, I trust but verify.

Speaker 3:

Yeah, oh, that's great, nice Everything. Yeah, I love that. I told him on a previous episode my love and passion for Angela Lansbury as JB Fletcher and murder. She wrote just simply because she you know, she, she digs deep, she really she is that sleuth, like you said, she scrutinizes and she always is asking the deeper questions and trying to get to the root cause. So I love that. So what would say it one more time for us?

Speaker 2:

You trust but verify, yeah, trust.

Speaker 3:

but verify and scrutinize everything. I love it. I love it. That's great, okay, well, this has been so great. Kristen is, I feel like you, just you're full of information, which is fantastic, is there? Anything Full of opinions maybe yeah, is there anything that you know you wanted to come into today's episode and share that I didn't really give you a chance to do yet? Did we miss something? Is there something big you want to share on either beers or deprescribing?

Speaker 2:

I think that I just want to make sure that you know everybody understands that, even if you aren't serving older folks in your practice currently, you're going to be dealing with older people right. Maybe it's your own aging grandparents or parents, your neighbors, friends from church, you know whatever. There's a growing amount of the population that is in this greater than 65-year-old category. People are older, they're more complex, and they all want to have improved health, but some of them just may not realize the importance of you know peelings and not just piling them on. So I think that older folks are desiring the pharmacist's expertise in this. I know that their adult children, who may not even live in the same city and state, are definitely desiring this, and so I think it behooves every pharmacist to become educated in this area.

Speaker 3:

Well, and I think it's because, as I'm aging myself, 65 doesn't seem that far off anymore and it doesn't really seem like an old person. You know, like I. Just so I want to be sure that we clarify that, that this is for you know, around that age like we're not talking about you start thinking about deprescribing at the age of 85. Like that's not what we're looking at. Start thinking about deprescribing at the age of 85, like that's not what we're looking at we're talking about. You know, very early in life still, where these things can make a big difference and can make a big impact. So I think that's something key to remember for our learners.

Speaker 2:

Yeah, you're right about that, Josh. 65 seems pretty young to me too. But there's a wide range of health complexity in that population. You've got some very healthy, you know, 65 or 85 year olds, but some very complex, medically complex 65 year olds, and and so again it goes back to that risk versus benefit argument.

Speaker 3:

Sure, Yep. So again, putting on our sleuth hat and trusting, but verifying. I love that. That's great, Awesome. Well, I think that's pretty much the time that we have for today. What I'd like to do with our guests before the end of every podcast is have you summarize again. Since our podcast is the Game Changers podcast, I'd like for you to summarize. What's the game changer here, Kristen? What's your take-home point for our learners? What would you like for them to walk away from this episode If they remember one thing what is the game changer here?

Speaker 2:

Sure, I think that people should know that the Beers Criteria most recent publication in 2023, is a great tool for pharmacists to use to help improve the lives of older patients Anybody and everybody over the age of 65,. This medication listing can be applied to help just generate a conversation about improved medication use and health for those older adults. The pharmacist is uniquely skilled in the effects of these medications and should use their knowledge to also provide suggestions for improved alternatives to the healthcare team. You can help patients, you can help providers and you can help the health systems that you interact with in that way.

Speaker 3:

That's great. That's great and, for those of you listening, if you are really interested in deprescribing, c-impact does have a course on deprescribing available to go deeper into the process and better understand polypharmacy and getting rid of a lot of medications that are just unnecessary. So across the board, not just for our aging population so that's something to check out if you're interested there. So that's all we have time for this week. Kristen, thank you so much for joining us today. It was a pleasure.

Speaker 2:

Thanks so much.

Speaker 3:

If you're a CE plan subscriber, be sure to claim your CE credit for this episode of Game Changers by logging in at CEimpactcom. And, as always, have a great week and keep learning. I can't wait to dig into another game-changing topic with you all again next week.