A long-awaited revision of the Beers criteria was released by the American Geriatrics Society (AGS) on October 8, 2015. This version, the second release since AGS began sponsoring and managing the criteria, is actually the 5th round of the document, which has for years influenced medication use in older adults, regardless of setting.
The Beers criteria was originally created in 1991 by geriatrician Mark H. Beers, MD, who sought to identify medications that were generally considered inappropriate for use in older adults, a novel concept at that time. Beers’ original list was based on the opinions of 13 nationally recognized experts in geriatrics and pharmacotherapy and focused on older adults in a nursing home setting.
For this round, a new list was added that describes certain medications that should only be used with great caution. In addition, a list of 13 specific medication combinations that may lead to harmful interactions was included, as well as 20 medications that require dosage adjustments or should be avoided in those with poor kidney function. The 2 original lists – medications that are potentially inappropriate for older adults – were updated from earlier iterations.
A new, novel list of suggested alternative medications and treatment options (not pharmaceuticals) was unveiled in this round. Multiple companion tools were also created, including a set of guiding principles for implementing prescribing recommendations. These principles are intended to help identify medications that might not be well-suited for older adults, not to specify a “Do Not Use” list nor to dictate prescribing protocols. These new tools, guidelines, and lists are welcome additions to the arsenal available for treating older adults.
An expert panel reviewed more than 6,700 clinical trials and studies produced since the Beers list was last updated in 2012, making this an important, new, evidence-based document for those caring for older adults.
Companion pieces to the 2015 AGS Beers criteria:
-How to use the American Geriatrics Society 2015 Beers Criteria—A Guide for Patients, Clinicians, Health Systems, and Payors
-2015 AGS Beers Criteria Alternatives List
-2015 AGS Beers Criteria and Evidence Tables
-Teaching Slides: How to Use the AGS 2015 Beers Criteria (available for a fee)
- What to do and what to ask if a medication you take is listed in the beers criteria
- Medications to avoid or use with caution
- Alternatives for medications listed in the AGS Beers Criteria
- Avoiding overmedication and adverse drug reactions
These companion articles make this an especially useful and interesting update of the now prominent Beers criteria.