Medications for Older Persons

Roger E. Thomas, MD, PhD, CCFP, FCFP, MRCGP, holds a BA Honors in Economics from Cambridge, PhD in Sociology from Yale, an MD from McMaster, and practiced as a rural physician 1979 in Newfoundland. Through 1980 to 1983, Dr. Thomas performed Medical Missionary work in Malawi. Through his career, Dr. Thomas has held faculty positions at East Carolina University, Toronto, Ottawa, Newfoundland, and currently is an Emeritus Professor of Family Medicine at the University of Calgary. He has 187 peer-reviewed publications and 108 abstracts on such topics as adverse medication events on seniors’ rehospitalization and death, prescribing for seniors using genomic data, evidence-based methods of deprescribing to reduce readmissions and death, total costs of seniors’ care and options to finance most needed care.

• Section 1. Recommendations for medications of older persons1. A summary of medications that most benefit older patients: for clinicians, patients, their families, policy makers and health ministries2. STOPP and American Geriatrics Society “potentially inappropriate medications" (PIMs) and START ”potential prescribing omissions” (PPOs)3. The Calgary study of 295,706 admissions of older persons to four acute care hospitals 2013-20214. Adverse drug interactions in the Veterans Affairs Adverse Drug Event Reporting System5. Pharmacokinetics and pharmacodynamics in older persons6. Methods to identify adverse drug interactions and effects7. How personalized medicine has changed senior patient outcomes at the Mayo Clinic and other centersSection 2. Older persons alcohol consumption, self-medication, and medication list accuracy8. Older persons alcohol consumption9. Self-medication and over the counter medications by older persons10. The accuracy of recording medication lists, transferring lists between community practitioners and medical institutions, and the potential effects on the accuracy of assessing PIMs, PPOs and adverse medication eventsSection 3. Cardiovascular medications11. Medications for hypertension12. Medications for heart failure13. Medications for arrhythmias14. Medications for diuresis15. Medications for coagulationSection 4. Central Nervous System medications16. Medications for depression17. Medications for anxiety18. Medications for insomnia19. Neuroleptic/antipsychotic medications20. Avoiding medications with risks of delirium21. Avoiding medications that augment dementiaSection 5. Renal medication22. Prescribing to reduce risks of renal insufficiency and failureSection 6. Gastrointestinal medications23. Prescribing to reduce the risks of peptic ulcer disease, gastritis, and esophagitis and treat if present24. Prescribing to reduce the risks of constipation or diarrheaSection 7. Musculoskeletal medications25. Medications for arthritis26. Medications for osteoporosisSection 8. Respiratory medications27. Medications for COPDSection 9. Endocrine medications28. Medications for diabetesSection 10. Pain medications29. Non-opioid analgesics and opioids for seniorsSection 11. Changing prescribing to prevent falls30. Prescribing to prevent falls

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