Prime Time Living 6.14.26 - Flipbook - Page 17
| Sunday, June 14, 2026
“One of my primary roles is to oversee chronic conditions, and those can
change – improve or deteriorate – so
updates are important. I strive to keep
the number of medications and each
one’s dosage as low as possible.
“As for supplements, I don’t recommend them. You get what you need
from eating a balanced diet, especially
western diets. Supplements aren’t regulated and there are often interactions
that affect other drugs you are taking.
Every single medication you take is first
absorbed into your body, then distributed to its target and has a life in your
body until it’s eliminated. (See accompanying article in this issue on nutrition.)
“Once you are on Medicare, there are
two annual options to review your health
status and medications. First, there is
an annual wellness checkup covered by
Medicare. Included is a review of your
medications.
“The second is available through Part
D, the Medicare drug plan. Included
in your annual subscription is a
Comprehensive Medical Review (CMR)
covered by your Part D provider. Call
your provider and find out who could do
this. It can be done either in person or
by phone. Afterwards, you get a complete personal medications list and an
action plan.”
Managing and Modifying
Medications
I asked Dr. Kai about medication education for physicians after I came across
a two-year program in pharmacology for
medical students in internal medicine.
“Medical knowledge, and science
knowledge as a whole, have exponentially grown for decades, and there
are limits to what we can know within
reason,” Dr. Kai responded. “This is
why pharmacists are a vital part of the
medical team. Not only are they integral
to safe and effective care, but often that
is the source of learning. We do garner
knowledge through conference lectures,
which include more detailed information
on treatment and management.”
One pharmacist stands out when it
comes to medications and older adults:
the highly respected and knowledgeable
Nicole Brandt, PharmD, M.B.A., BCGP,
FASCP, professor of practice, sciences,
and health outcomes research, ParkeDavis Chair in geriatric pharmacotherapy, executive director of the Peter Lamy
Center on Drug Therapy and Aging at
the University of Maryland School of
Pharmacy.
Brandt was named the 2019 recipient
of the American Geriatrics Society’s
(AGS) Dennis W. Jahnigen Memorial
Award for her leadership in geriatrics
education. She has worked on various
interdisciplinary teams across numerous
practice settings and is currently leading initiatives to integrate sustainable
pharmacist-directed services to help
older adults with multiple co-morbidities
at the MedStar Center for Successful
Aging.
The AGS is a society of geriatrics
health care professionals dedicated to
improving the health, independence,
and quality of life of older people. Brandt
fits right in.
She is passionate about geriatric
pharmacology and, as seen in the list
of her various roles, she wants older
adults to live full and healthy lives. She
is assiduous in educating pharmacy
students why they should work in the
geriatrics and gerontology space. And,
although you don’t see this credit on
her bio, Brandt has been a member of
the multidisciplinary panel and one of
the authors of the American Geriatrics
Society’s Beers Criteria for Potentially
Inappropriate Medication Use in Older
Adults since 2012. The first version was
published in 1991. Often referred to as
the Beers List, it is a bible of medications older adults should not take and
why.
The American Geriatric Society (www.
americangeriatrics.org) 2023 Beers
Criteria “includes lists of certain medications worth discussing with health
professionals because they may not be
the safest or most appropriate options
for older adults. Though not an exhaustive catalogue, the five lists included in
the AGS Beers Criteria describe particular medications with evidence suggesting they should be:
• Avoided by most older people (outside of hospice and palliative care
settings);
• Avoided by older people with specific health conditions;
• Avoided in combination with other
treatments because of the risk for
harmful “drug-drug” interactions;
• Used with caution because of the
potential for harmful side effects; or
• Dosed differently or avoided among
people with reduced kidney function, which impacts how the body
processes medicine.”
The AGS is committed to bringing
the expertise of geriatrics health professionals to the public; lay versions
of the Beers Criteria as well as tools
to aid older adults and caregivers in
understanding what medications are
potentially inappropriate are available
for free from www.healthinaging.org/
medications-older-adults. It is available in ‘read only’ form at https://
agsjournals.onlinelibrary.wiley.com/doi/
epdf/10.1111/jgs.18372.
Last year, there was an addendum
to the Beers Criteria: “Alternative
Treatments to Selected Medications in
the 2023 American Geriatrics Society
Beers Criteria, an updated clinical resource designed to help health
care professionals identify safer, more
appropriate treatment options for older
adults.”
Brandt is a huge advocate for deprescribing. Most doctors don’t revisit the
need or requirement for something they
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prescribed in the past. Often, this inaction contributes to the occurrence of
polypharmacy. She recommends you
review your medications with your
healthcare professional to determine if
it’s still necessary. Here’s your script:
Questions to ask your doctor,
pharmacist or nurse
• Why am I taking this medication?
• How will you know if it’s working?
• When should I start feeling better?
• How long should I continue to take
it?
• What are the potential benefits and
harms of this medication? Side
effects to watch for and what to do
about them?
• Can it affect my memory or cause
me to fall?
• Can I stop or reduce the dose of
this medication (i.e. deprescribing)?
• Who do I follow up with and when?
Brandt and Kai are two dedicated
professionals who understand how we
are affected, positively and negatively,
by something most of us don’t necessarily understand. We are dependent on
our clinicians to protect us from adverse
events due to our prescribed drugs,
and, when we are ill, to support and heal
us. They set a standard to which we all
should aspire.
