Estimating the Use of Potentially Inappropriate Medications Among Older Adults in the United States

J Am Geriatr Soc. 2020 Dec;68(12):2927-2930. doi: 10.1111/jgs.16779. Epub 2020 Aug 25.


Objectives: Inappropriate prescribing of medications is common in health care, and is an important safety concern, especially for older adults, who have a high burden of comorbidity and are at greater risk for medication-related adverse events. This study aims to estimate the extent and cost of potentially inappropriate prescribing of medications to older adults in the United States.

Design: A cross-sectional study.

Setting: Medicare Part D Prescription Drug Program data set (2014-2018).

Participants: Older adults who were enrolled in Medicare Part D Prescription Drug Program between 2014 and 2018.

Measurements: Potentially inappropriate medications were identified using the 2019 American Geriatrics Society Beers Criteria®.

Results: In 2018, 7.3 billion doses of potentially inappropriate medications were dispensed. The most common medications by number of doses dispensed were proton pump inhibitors, benzodiazepines, and tricyclic antidepressants, and the top five unique medications by reported spending were dexlansoprazole, esomeprazole, omeprazole, dronedarone, and conjugated estrogens. From 2014 to 2018, 43 billion doses of potentially inappropriate medications were dispensed, with a reported spending of $25.2 billion.

Conclusion: Potentially inappropriate medication use among older adults is both common and costly. Careful attention to potentially inappropriate medication use and deprescribing when clinically appropriate could reduce costs and potentially improve outcomes among older adults.

Keywords: Medicare Part D; older adults; potentially inappropriate prescribing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents, Tricyclic / adverse effects
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Geriatrics
  • Humans
  • Inappropriate Prescribing / adverse effects
  • Inappropriate Prescribing / economics*
  • Inappropriate Prescribing / statistics & numerical data*
  • Male
  • Medicare Part D / economics*
  • Medicare Part D / statistics & numerical data
  • Polypharmacy*
  • Potentially Inappropriate Medication List / statistics & numerical data*
  • Proton Pump Inhibitors / adverse effects
  • Proton Pump Inhibitors / therapeutic use
  • United States


  • Antidepressive Agents, Tricyclic
  • Proton Pump Inhibitors
  • Benzodiazepines