The American Geriatrics Society (AGS) today released its second updated and expanded Beers Criteria--lists of potentially inappropriate medications for older adults who are not receiving hospice or palliative care, and one of the most frequently cited reference tools in the field of geriatrics. The Society also unveiled a suite of new companion resources--including a list of alternative therapies for potentially inappropriate medications and more detailed guidance on best practices for implementing AGS recommendations--all published online in the Journal of the American Geriatrics Society and available for free from GeriatricsCareOnline.org.
A panel of 13 experts convened by the AGS identified more than 40 potentially problematic medications or classes of medications organized across five lists. Updated from earlier iterations of the AGS Beers Criteria, two lists detail potentially inappropriate medications for most older adults or for those with specific conditions; an additional list describes certain medications that should be used only with considerable caution. Two new additions to the 2015 AGS Beers Criteria include a specific list of medication combinations that may lead to harmful interactions, as well as a separate synthesis of some medications that should be avoided or dosed differently for people with poor kidney function.
Recognizing that older adults, healthcare professionals, and health plans might benefit from suggestions for evidence-based alternatives to potentially inappropriate medications, the expert panel also unveiled the AGS's first list of certain suggested alternative medications and treatment options outside pharmaceuticals. Used in tandem with the AGS Beers Criteria, this list of alternatives provides additional guidance for clinicians and the older adults they care for, who are prescribed medication more frequently than any other age group in the U.S.
"As we grow older, at least one in six of us is likely to experience serious side effects directly related to the medications we take," explains Todd P. Semla, PharmD, MS, AGSF, co-chair of the AGS Beers Criteria expert panel. Added Donna Fick, PhD, RN, GCNS-BC, FGSA, FAAN, expert panel co-chair: "The AGS Beers Criteria offer guidance to clinicians and the public for talking about medications with risks that may outweigh benefits. It's important to remember that many of these medications are considered potentially inappropriate only in certain circumstances and for certain people. Tools like the AGS Beers Criteria can do much to support medication use that is safe, effective, and responsive to each person's health needs."
The expert panel convened by the AGS reviewed more than 6,700 clinical trials and research studies from a pool of more than 20,000 articles published since the last AGS Beers Criteria update in 2012. The panel's revisions inform specific (though not exhaustive) lists of medications that may be harmful to older adults. As part of the 2015 update, the AGS Beers Criteria now include:
"For more than 20 years, the Beers Criteria have led to decreased reliance on potentially inappropriate medications and a deeper appreciation for medication safety as a facet of high-quality care for older adults," notes AGS President Steven R. Counsell, MD, AGSF. "Our 2015 update extends the legacy of the late Mark Beers, MD--who led creation of the first list in 1991. Our 2015 update was developed after a review of the latest evidence, and we have created new companion tools intended to help older people, health professionals, and other stakeholders appreciate the AGS Beers Criteria as a resource, not a replacement, for sound clinical judgment on a case-by-case basis," Dr. Counsell said.
In addition to the highly anticipated list of possible alternate therapies for medications identified as potentially inappropriate, companion tools released with the 2015 AGS Beers Criteria update also include a separate set of guiding principles for implementing prescribing recommendations. Among these core tenets, expert panelists reiterated that:
The AGS issued its first revision to the Beers Criteria in 2012, one year after assuming responsibility for the resource. Since that time, the AGS Beers Criteria have played a central role in high-quality care for older adults, influencing everything from research and professional education to care quality measures and health policy decisions.
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About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Its more than 6,200 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit americangeriatrics.org .
Journal of the American Geriatrics Society