Donna Fick, professor of nursing at Penn State, co-chaired (along with Todd Semla, clinical pharmacy specialist for the U.S. Department of Veterans Affairs) a panel of clinical experts in geriatrics and pharmacotherapy that was responsible for updating the American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
The revised criteria were published March 1 in the Journal of the American Geriatrics Society and at the AGS website.
The panel was convened in 2011 to revise and expand the criteria (last revised in 2003) based on the latest research and using the Institute of Medicine (IOM) guidelines for developing practice guidelines. The society plans to update the criteria every three years from now on.
The 2012 Beers Criteria can help clinicians more safely prescribe medications for older adults (age 65 and older) by identifying those that are potentially dangerous. The new criteria include 53 medications and classes of medications identified as potentially problematic. These medications are grouped into three categories: those with high risks of side effects or limited effectiveness; those that may exacerbate certain diseases, risk factors, or disorders; and those to be used “with caution” because they may pose greater risks for older adults in general -- a new category added to the 2012 update.
“The AGS Beers Criteria can be easily integrated into the electronic health record and should be used as a guide for both health professionals and consumers in making safer medication choices,” Fick said. “However, an older adult should never stop a drug just because it is on this list. Always discuss medications with your health provider before stopping or starting a drug."
“Many of the medications on this list have adverse effects on the central nervous system and can lead to falls and acute confusion, both of which are preventable in older adults,” Fick said, noting that the School of Nursing is currently conducting NIH-funded research that tests nondrug approaches to delirium in persons with dementia.
The Beers Criteria are widely used in clinical practice and in national quality measures. They were first published in 1991 by the late Mark H. Beers, a geriatrician and editor of the Merck Manuals and the Merck Manual of Geriatrics.