Donna M. Fick, PhD, RN, GCNS-BC, FGSA, FAAN
Todd P. Semla, PharmD, MS, AGSF
Co-Chairs of the 2015 Updated AGS Beers Criteria Expert Panel
Today, the American Geriatrics Society (AGS) released its 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. For more than 20 years, the Beers Criteria have served as a valued resource for healthcare professionals about the safety of prescribing medications to older adults. In fact, the AGS Beers Criteria have become one of the most frequently used reference tools in the field of geriatrics. The AGS Beers Criteria were previously updated in 2012.
How We Updated the Beers Criteria
The 2015 Updated AGS Beers Criteria reflect work done by a panel of 13 geriatrics experts convened by the AGS. The panel searched for clinical trials and research studies since the 2012 AGS Beers Criteria were issued, and found more than 20,000 results! From this pool, our team reviewed more than 6,700 studies. From there, we were able to identify more than 40 potentially problematic medications or classes of medications, which we organized into five lists. While these lists aren’t exhaustive, they can be very helpful as conversation-starters between older adults and their healthcare providers about what treatment options work best from one individual to the next.
In addition to updating two lists of medications that may be potentially harmful for people aged 65 and older who are not receiving palliative or hospice care, the 2015 Updated AGS Beers Criteria now contain:
- Separate guidance on avoiding 13 combinations of medications known to cause harmful “drug-drug interactions.” Some medications may be inappropriate when prescribed together because they can increase an older adult’s risk for falls, fractures, or urinary incontinence, for example.
- A list of 20 potentially problematic medications to avoid or for which doses should be adjusted depending on an older person’s kidney function. These medications could raise risks for problems such as nausea, diarrhea, bleeding, problems affecting the brain and nervous system, and changes in mental well-being and bone marrow toxicity (a condition in which bone marrow makes fewer blood cells).
- Three new medications and two new “classes” of medications added to the Criteria. An example of a new class of medication includes the proton-pump inhibitors that some people take for acid reflux or stomach ulcers. Recent studies have linked these medications to an increased risk for bone loss, fractures, and serious bacterial infections, which is why they were added to the 2015 AGS Beers Criteria.
What You Should Know
It’s very important to remember that potentially inappropriate medications are just that—potentially inappropriate. They should be considered carefully, but that doesn’t mean they’re universally “bad” in all cases or for all people. In fact, your healthcare providers are often in the best position to determine what treatment options will work for you, so it’s important to begin any decision-making process with them first.
If you are taking a medication included on an AGS Beers Criteria list, be sure to:
- Talk with your healthcare provider before you consider stopping treatment. Never stop taking a prescribed medication without your healthcare provider’s approval.
- Ask your healthcare provider whether you could take a safer alternative medication, or if there’s a safer therapy to use instead of a medication that’s listed on the AGS Beers Criteria.
- Discuss all the medications you’re taking with your healthcare provider.
- Ask whether the medications are effective for your health conditions and concerns, and whether any symptoms you have could be due to medication side effects.
- Use only trusted, reliable sources to find information on your medications, such as MedlinePlus.
The Health in Aging Foundation has created these reader-friendly materials to help older adults and their caregivers understand the AGS Beers Criteria and how healthcare providers should use such tools to promote safe prescribing for older adults: