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High Risk Medications for Elderly Patients

The Centers for Medicare & Medicaid Services (CMS) continues to work to improve and drive the quality of care that Medicare beneficiaries receive from their physicians and health plans. Certain drugs with high risk of side effects should be avoided in the Medicare population when there may be safer drug choices. Decreasing the rate of usage of high risk medications will directly aid in improvement of clinical outcomes, improvement in quality of life, reduction of morbidity and mortality and lower health care costs.

How can you reduce inappropriate prescribing in the elderly?

  1. Determine whether drug therapy is truly necessary.
  2. Review patients' medications at every visit.
  3. Educate your patients.
  4. Avoid inappropriate medications and choose safer alternatives.

EmblemHealth recently updated the high risk medication list to reflect CMS updates. To help keep our members safe, please evaluate your patientsí drug treatment regimens and continue to discuss the risk factors associated with these high risk medications. Here are the top 24 utilized high risk medications:

CMS: High Risk Medications for Patients Over Age 65
Amitriptyline Doxepin Glyburide/Metformin Methocarbamol
Benztropine Estradiol Hydroxyzine HCl Nitrofurantoin Macrocrystal
Carisoprodol Estrogen w/
Hydroxyzine Pamoate Nitrofurantoin Monohydrate
Clomipramine Estrogens, conjugated Imipramine Promethazine
Cyclobenzaprine Eszopiclone Indomethacin Trihexyphenidyl
Digoxin Glyburide Megestrol Zolpidem

We have published a comprehensive list of high risk medications with additional information and suggested alternatives. You may also review the complete NCQA List on their Web site.


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