Potentially inappropriate medications for older adults originally conceived by dr. The beers criteria are a valuable tool for clinical care and quality improvement but may be misinterpreted and implemented in ways that cause unintended harms. Updating the beers criteria for potentially inappropriate. The american geriatrics society is updating its list of medications that can be problematic for older adults. First published in 1991, the criteria have been updated four times, the most recent iteration being published in 2015. Explicit criteria as clinical tools to minimize inappropriate medication. New to the criteria are lists of select drugs that should be avoided or have their dose adjusted based on the individuals kidney function and. The 2019 american geriatrics society updated beers. Using a beers criteria based eductaional intervention to increase practitioners knowledge and confidence of potentially inappropriate medications with older adults 2015. This study aims to compare, both qualitatively and quantitatively, the medication dispensed to elderly patients in a primary health care center phc and a community pharmacy cp in argentina and to identify the prescription of potentially inappropriate medications pims. This study is an important update of previously established criteria that have been widely used and cited.
The goal of the 2015 american geriatric society ags beers criteria continues to be improving the care of older adults by reducing their exposure to potentially inappropriate medications pims. The beers criteria were developed to improve prescribing practices for older adult patients to reduce or avoid potential risks and complications. The use of beers criteria drugs in older people has been shown to be. The 2015 american geriatrics society ags beers criteria are presented. The beers criteria for potentially inappropriate medication use in older adults, commonly called the beers list, are guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults. The american geriatric society has updated the beers criteria list based on evidencebased recommendations. Like the 2012 ags beers criteria, they include lists of potentially. Refer to the 2015 beers criteria to learn more on significant interactions impacting. A comparison of the stoppstart criteria and the beers. Using a beers criteriabased eductaional intervention to. Urologists should be aware of how these medications are classified under the beers criteria and what the implications are for clinical practice with older patients. By the american geriatrics society 2015 beers criteria update expert panel. Geriatrics society updates list of inappropriate drugs medscape. The ags cocare programs provide you with tools, resources, education, and support.
These criteria are not meant to be applied in a punitive manner. The stopp and start criteria were first published in 2008, 23 and revised in 2015. The 2015 american geriatrics society updated beers criteria. Article information, pdf download for explicit criteria as clinical tools to minimize. American geriatrics society 2019 updated ags beers criteria for. Intent of criteria the 2012 ags beers criteria are intended for use in all ambulatory and institutional settings of care for populations aged 65 and older in the united states. Geriatrics society updates list of inappropriate drugs. In addition to the benzodiazepines, the beers criteria or list has included amiodarone, amitriptyline, cimetidine, clonidine, disopyramide, indomethacin, ketorolac. This article describes the intended role of the 2015 american geriatrics society ags beers criteria and provides guidance on how patients, clinicians, health systems, and payors should use them. Potentially inappropriate medications in elderly ambulatory. The goal of the 2015 ags beers criteria continues to. Some highlights of the potential medication issues mentioned in the latest version of the beers criteria include. The 2019 ags beers criteria is the third such update by the ags and the.
Pdf healthcare outcomes associated with beers criteria. The stopp criteria have been suggested to detect more pims in european elderly than the beers criteria. The updated report was published in the journal of the american geriatric society. The 2019 american geriatrics society updated beers criteria. Controversial changes to the socalled beers criteria are in the works. Like the 2012 ags beers criteria, they include lists of potentially inappropriate medications to be avoided in older adults. Ags 2015 beers criteria the american geriatrics society geriatrics health professionals. American geriatrics society 2015 beers criteria update expert panel. The goal of the 2015 ags beers criteria continues to be improving the care of older adults by reducing their exposure to pims. In general, there are no firm rules for how to taper and discontinue potentially deliriogenic medications, as both the need to taper and the best strategy for doing so depends on a number.
Criteria for safe medication use in older adults for people over 65 years of age. Beers formulated the beers criteria through a consensus panel of experts using the delphi method. Considerations and resources for deprescribing in older. Implications for medication use in the elderly fifteenth annual focus conference november 16, 2016 william simonson, pharmd, cgp, fascp oregon state university college of pharmacy e. Hartford foundationfunded project provided to the hartford institute for geriatric nursing at new york universitys college of nursing in collaboration with the american journal of. These were first issued in 1991 and have been updated repeatedly over the years.
Potentially inappropriate medications in a sample of. Several criteria have been developed to identify pim usage in older people, with beers criteria 4 being the most widely used. With more than 90% of older people using at least one prescription and more than 66% using three or more in any given month, the ags beers criteria plays a vital role in helping health professionals, older adults, and caregivers work together to ensure medications are appropriate. Updated beers criteria for potentially inappropriate medication use in older adults potentially inappropriate medications pims continue to be prescribed and used as firstline treatment for the most vulnerable of older adults, despite evidence of poor outcomes from the use of pims in older adults. Beers list medication use was flagged for potential improvement in recent reports of the health quality ontario 16 and the ministry of health and longterm care 17. We encourage clinicians to educate themselves about the beers criteria recommendations and associated initiatives that are aimed at improving the care of older adult patients. We at the kuwait clinical pharmacy network have a duty to ensure the safety of all. Beers was the principal author of the original 1991 criteria. First issued in 1991, these criteria have been repeatedly revised and updated. Background potentially inappropriate medications pims are often found in high proportion among the elderly population. Objective this study aimed to determine the prevalence of pims and potential prescribing omissions ppos in a sample of portuguese. A key theme underlying these recommendations is to use common sense and clinical judgment in applying the 2015 ags beers criteria and to remain. American geriatrics society 2019 updated ags beers. Pdf beers versus stopp criteria in polyharmacy community.
Greenberg, phd, rn, gnpbc, the hartford institute for geriatric nursing, new york university rory meyers college of nursing issue number 16, revised 2019 why. Abbreviated beers list of medications with in creased risk of adverse drug events in patients over 65 medications reason that use is a problem pain relievers propoxyphene and combination products used to control pain. The criteria have met with some criticism for being too simplistic, failing to account for clinical judgment and lacking translation into measurable quality improvements. Beers criteria for potentially inappropriate medication use in older adults. This is accomplished by using the criteria as an educational tool and quality measuretwo uses that are not always in agreement. Consensusbased, but statistical association with adverse drug events adopted for nursing home regulation. Stoppstart criteria for potentially inappropriate prescribing in older people. This was accomplished through the support of the american geriatrics society ags and the work of an interdisciplinary panel of 11 experts in. A list of such drugs was first published in 1991 and has been periodically revised by specialists in geriatrics. Pdf to examine healthcare outcomes associated with beers criteria of. The 2015 american geriatrics society beers criteria. Dec 02, 2015 american geriatrics society 2015 beers criteria update expert panel. Safer medication use in older persons information page. Dec 16, 2016 american geriatrics society 2015 updated beers criteria for potentially inappropriate medication use in older adults.
Ccanadian list drug drug concern alternative treatment analgesics ketorolac toradol b. They emphasize deprescribing medications that are unnecessary, which helps to reduce the problems of polypharmacy, drug interactions, and. A guide as part of 2015 update of the beers criteria, ags created a workgroup to encourage optimal use of the criteria by patients, clinicians, health systems, and payors included input from key stakeholders workgroup developed. This article describes the intended role of the 2015 american geriatrics society ags beers criteria and provides guidance on how patients, clinicians, health systems, and payors should. The beers criteria and specifc medications of interest to urology several medications commonly used in urologic care are included in the 2012 beers criteria revision. American geriatrics society 2015 updated beers criteria. American geriatrics society updated beers criteria for. Version 2 of stopp consists of 81 criteria organized into categoriesfor example, cardiovascular, renal, respiratory, drugs that increase fall. Beers criteria are the most widely used criteria to evaluate potentially inappropriate prescribing in people over the age of 65 years. The 2015 ags beers criteria were developed fol lowing a. Ortho tm is an evidencebased geriatricsorthopedics comanagement model that can be implemented throughout your health system. Ags guidelines, recommendations, and position statements are always free to ags members and available to the wider community of geriatrics healthcare professionals. The criteria were originally published in the archives of internal medicine in 1991 and updated in 1997, 2003, 2012, 2015, and most recently in january 2019. American geriatrics society 2015 updated beers criteria for potentially inappropriate medication use in older adults.
The purpose of this initiative was to revise and update the beers criteria for potentially inappropriate medication use in adults 65 years and older in the united states. Beers criteria for potentially inappropriate medication. The anticholinergic drug scale as a measure of drugrelated anticholinergic burden. Using a beers criteriabased eductaional intervention to increase practitioners knowledge and confidence of potentially inappropriate medications with older adults 2015. Beers criteria is to improve care of older adults by reducing imu, reducing. Overthecounter medications potentially inappropriate for the elderly. The campaign on safer medication use in older persons began as a collaborative effort to reduce the use of beers list drugs in longterm care homes across ontario. Beers criteria are guidelines regarding medication usage in elders.
The 2015 american geriatrics society updated beers. Careful application of the criteria by health professionals, consumers, payors, and health systems should lead to closer monitoring of drug use in older adults. The 2015 updated beers criteria for potentially inappropriate medication use in older adults added nonbenzodiazepine receptor agonist hypnotics ie, zolpidem, zaleplon, and eszopiclone as medications to avoid in patients who have dementia because of adverse cns effects. The american geriatric society beers criteria identify medications associated with risks that may be greater than their benefits for people aged 65 and older.
In addition to the benzodiazepines, the beers criteria or list has included amiodarone, amitriptyline, cimetidine, clonidine, disopyramide, indomethacin, ketorolac, meperidine, methyldopa, and. The primary target audience is the practicing clinician. Mark beers published in 1991, revised 1997, 2002, 2012, 2015, 2018. The use of beers criteria drugs in older people has been shown to be associated with an elevated. For potentially inappropriate medication use in older adults from the american geriatrics society this clinical tool, based on the ags 2012 updated beers criteria for potentially inappropriate medication use in older adults ags 2012 beers criteria, has been developed to assist healthcare providers in improving medication safety in older adults. Updated ags beers criteria making medical treatment decisions for unbefriended older adults. Incorporate new evidence on pims included in the 2015 ags. American geriatrics society 2015 updated beers criteria for. Beers criteria should be used with clinical judgment and common sense keep in mind key principles to help you best use beers criteria in practice warning light use resources and direct your patients to them too beers criteria marcum, nw gwec winter 2020 21. Help tm provides the latest tools and handson guidance to make delirium prevention a reality.
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