As the overall population of the United States continues to age, so too does the workforce. As of June 2019, the U.S. Census Bureau reported that the median age in the United States increased to 38.2 years of age in 2018. This is up from 37.2 years in 2010, a nearly 3% increase over an eight year period. This trend will only continue to grow, as the Bureau of Labor Statistics (BLS) expects that approximately 25% of the labor force will be age 55 years and older by 2024, of whom, 8% are expected to be 65 years and older. In fact, the age groups between 65 to 74 years and 75 years and older are expected to have the fastest growth rates of any in the workforce.
While these trends are related to an overall aging population, there are certain factors that apply specifically to older workers. According to a recent white paper from workers’ compensation pharmacy benefit manager (PBM) myMatrixx, many workers are choosing to stay in the workforce past the Social Security retirement age of 66 years and two months. Reasons for this include more workers holding advanced degrees, an overall increase in health and medical care and many people wanting to fully realize their economic goals to account for a longer life expectancy.
With an older workforce comes a number of unique concerns for employers, insurance payers and risk managers alike. Shanea McKinney, Clinical Account Executive for myMatrixx, explains it like this, “Although older workers are actually less likely to get injured, there is a higher likelihood of severe injuries and even fatalities when they do occur. This can lead to increased return to work times as well as medical and indemnity costs.” To lower the likelihood of these injuries occurring and improve outcomes and mitigate costs when they do occur, stakeholders can benefit from an understanding of the most common work-related issues and treatment guidelines affecting older workers. McKinney particularly stresses the importance of the American Geriatric Society’s (AGS) Beers Criteria in administering medications for an older workforce.
What are Beers Criteria and Why Is It Critical to Follow These Guidelines?
To support clinicians in the prescribing, administering and dispensing of medications for older adults, the AGS established the Beers Criteria, originally created by geriatrician, Mark Beers. “As we continue to provide clinical consultation services to address the needs of workers’ compensation payers, we added the Beers Criteria to our own Clinical Analysis Criteria,” says McKinney. The goal of these guidelines from a pharmaceutical standpoint is to assess high-risk patients on medication therapy for potential clinical intervention.
According to the study, common issues among older workers are cardiovascular diseases, thyroid diseases and pain due to arthritis and osteoporosis. Data demonstrates that while opioids are the number one class of medications utilized by injured employees 65 years and older, anti-hypertensive agents followed by lipid lowering medications are also among the top 10 medication classes for this patient population. Typical prescribing cascades should also be expected with these and other conditions as well as prescription transaction history. This includes the use of one or more hypertensive medications, branded thyroid and antidepressant medicines.
By analyzing patterns of injured employees aged 65 and older, the study identified that about one in three patients were being prescribed and dispensed a medication directly addressed for avoidance by the Beers Criteria. As a result, their clinical pharmacists are taking action to intervene on these prescribing patterns.
Dedicated management for an aging population
While the AGS clearly states that the Beers Criteria recommendations should not supersede the clinical judgment of the prescriber, nor disregard the risk-reward of a particular therapy based upon the overall treatment goals, caution and close monitoring is advised to ensure patient safety. “At myMatrixx, we take the AGS’s recommendations into close consideration during our prescriber discussions to ensure patient age, comorbidities and medication regimens across practitioners are not overlooked,” says McKinney.
For any clinical program dealing with older workers, the report recommends putting initiatives in place to facilitate prescriber and patient outreach when Beers Criteria concerns arise. As employers of today begin to embrace the aging workforce of the future, it will be critically important to ensure that the organization’s workers’ comp program remains highly aware of the distinct needs of this growing group of employees.