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Content Update

December 21, 2023

Reacting to the Rise of Respiratory Syncytial Virus: An Update on Prevention: In 2023, the U.S. Food and Drug Administration (FDA) approved several prophylactic measures against the respiratory syncytial virus (RSV): 1) Nirsevimab (Beyfortus®) for the pediatric population; 2) a recombinant, adjuvanted RSVPreF3 vaccine (Arexvy®) for the geriatric population; and 3) a bivalent RSVpreF vaccine (Abrysvo®) for the pregnant and geriatric populations. Compared to palivizumab, the previous standard of care, nirsevimab has an extended half-life and convenient single-dosing schedule. Abrysvo® and Arexvy® are recommended by the Centers for Disease Control and Prevention (CDC) as single dose RSV vaccine options for adults 60 and older with shared decision making. Additionally, Abrysvo® is recommended in pregnant women at 32-36 weeks gestational age. Adverse effects (AEs) were mostly minor, although neurological AEs (e.g. Guillain-Barre syndrome) were noted in a small number of patients.

Content Update

July 26, 2023

2023 Update to the AGS Beers Criteria®: The American Geriatrics Society (AGS) convenes an expert panel to regularly update the Beers Criteria, a list of potentially inappropriate medications for use by older adults (≥ 65 years) in most healthcare settings, except hospice and end-of-life care. Since the last update in 2019, a 12-member panel of interprofessional geriatrics experts used a systematic review and a modified Delphi method to prepare and publish the latest update in May 2023. The 2023 AGS Beers Criteria® includes 36 medications/classes with “avoid” recommendations and 8 classes to be used with caution, while removing 33 medications for low use or not being available in the United States. The 2023 AGS Beers Criteria® is designed to ensure safe medication use in older people and supports shared decision-making by patient-provider teams. Changes to the criteria are described in this update.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Explain changing aging population demographics.

  2. Discuss age-related pharmacokinetic and pharmacodynamic changes.

  3. Identify drug-related problems and associated morbidities commonly experienced by older adults.

  4. Describe major components of geriatric assessment.

  5. Recognize interprofessional patient care functions in various geriatric practice settings.

INTRODUCTION

The growth of the aging population and increasing lifespan require healthcare professionals to gain knowledge necessary to meet the needs of this patient group. Despite the availability and benefit of numerous pharmacotherapies, older patients commonly experience drug-related problems, resulting in additional morbidities. Therefore, it is essential for clinicians serving older adults across all healthcare settings to understand the epidemiology of aging, age-related physiological changes, drug-related problems prevalent in elders, comprehensive geriatric assessment, and interprofessional approaches to care.

EPIDEMIOLOGY AND ETIOLOGY

As humans age, they are at increasing risk of disease, disability, and death for three reasons: genetic predisposition; reduced immunological surveillance; and the accumulated effects ...

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