The 4Ms of Age Friendly Healthcare Delivery: Medications

The 4Ms of Age Friendly Healthcare Delivery: Medications - #104

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Medications is one of the 4Ms of an Age-Friendly healthcare system.

In 2017, the Institute for Healthcare Improvement (IHI), the John A Hartford Foundation (JAHF), the American Hospital Association (AHA), and the Catholic Health Association (CHA) of the United States addressed the development of age-friendly health systems using a clinical framework to improve the complex care of older adults.

These organizations defined and operationalized age-friendly care following the guidelines of beneficence, evidence-based medicine, and patient/family aligned goals and concerns. The 4M Framework was the result: What Matters Most, Mentation, Mobility, and Medication.  A 5th M is often incorporated to include Multi-Morbidity, which calls attention to the multiple, often inter-related, health problems that many older adults face.

Older adults in the outpatient and inpatient setting.

Assess medication choice and use in older adult patients by considering geriatric principles of prescribing.

  1. Identify principles of prescribing medications in the elderly.
  2. Identify tools or databases for safe prescribing and drug interactions.
  1. Institute for Healthcare Improvement.  Age-Friendly Health Systems: Guide to Using the 4Ms in the Care of Older Adults.  July 2020.   http://www.ihi.org/Engage/Initiatives/Age-Friendly-Health-Systems/Documents/IHIAgeFriendlyHealthSystems_GuidetoUsing4MsCare.pdf
  2. Hales MD et al. Prescription Drug Use Among Adults Aged 40-79 in the United States and Canada. NCHS Data Brief No. 347, August 2019.
  3. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.  By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel.J Am Geriatr Soc. 2019 Apr;67(4):674-694. doi: 10.1111/jgs.15767. Epub 2019 Jan 29.PMID: 30693946
This GFF ___ my competence in geriatrics.

Steven Denson MD, Associate Professor, Division of Geriatric and Palliative Medicine, Medical College of Wisconsin