Journal of the American Geriatrics Society Study Says Higher Test Scores Correlated with Fewer Dangerous Drug Prescriptions.
Philadelphia, PA, September 8, 2021 – Physicians with higher scores on the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) assessments were less likely to prescribe “potentially inappropriate medications” (PIMs) to their older patients – including anticholinergics, which have been linked to cognitive impairment and decline in older patients, according to a study by ABIM researchers. In younger patients, anticholinergic medications are frequently prescribed to treat colds and allergies as well as gastrointestinal, genitourinary and many other disorders.
The study, which was published in the Journal of the American Geriatrics Society (AGS), looked at how 8,196 general internists prescribed 72 different medications, such as tricyclic antidepressants, skeletal muscle relaxants and long-acting sulfonylureas, which are considered potentially inappropriate for older patients by the AGS Beers criteria® guidelines. The AGS Beers criteria®, which guides safe medication use in adults more than 65 years of age, advises against using certain drugs because the medications' risks start to outweigh the benefits in older adults.
The study found that 8,196 general internists prescribed at least one inappropriate medication to 11% of the 875,132 patients age 65 and older they saw in a year compared with appropriate medications, which they prescribed to 57% of their patients. Being seen by a top performing versus bottom performing physician, as measured by the ABIM MOC assessment, was associated with an 8.6% lower chance of being prescribed an inappropriate medication and a 4.7% higher chance of being prescribed an appropriate medication.
“There's a powerful patient safety message in our conclusions because if all internists prescribed similarly to those who scored well on their assessments, then about 40,000 fewer patients with Medicare part D insurance would be prescribed one of these potentially dangerous medications each year.” said lead author Jonathan Vandergrift.
Vandergrift added, “the research continues to demonstrate the value and importance of physicians staying current and aware of changes in medicine. This is one of a growing body of work that shows the importance of physician knowledge as reflected in ABIM's MOC assessments.”
ABIM and Harvard Medical School collaborated on two recent published studies that showed physicians with higher scores on the ABIM MOC assessment were less likely to prescribe opioids unnecessarily for lower back pain, and less likely to make a diagnostic error that led death or hospitalization.
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Internists and subspecialists who earn and maintain board certification from the American Board of Internal Medicine (ABIM) differentiate themselves every day through their specialized knowledge and commitment to continual learning in service of their patients. Established as an independent nonprofit more than 80 years ago, ABIM continues to be driven by doctors who want to achieve higher standards for better care in a rapidly changing world. Visit ABIM's blog to learn more and follow ABIM on Facebook, Twitter and Instagram. ABIM is a member of the American Board of Medical Specialties.