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A closer look at the 2019 Beers criteria

  • Therapy in Practice
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Abstract

Increased use of potentially inappropriate medications (PIMs) is one of the major issues arising in older adults. The use of PIMs has been found to be associated with adverse drug events, drug-related problems and other major significant health consequences. However, PIMs continue to be prescribed as first-line drugs in older adults in many parts of the world. Beers criteria for PIM use were first established by Mark Beers in 1991 and the criteria have been updated multiple times by Mark Beers and the American Geriatric Society. The Beers criteria for PIM use are a specially designed tool to improve medication selection and reduce adverse drug events in older adults. The expert panel made some noteworthy changes in the 2019 Beers criteria update. The purpose of this review is to highlight noteworthy changes and to provide additional details and rationale behind the selected noteworthy changes within the 2019 criteria. This review will aid healthcare professionals to apply the 2019 Beers criteria in their clinical judgment when selecting drug therapy for older adults.

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References

  1. Jones JK. Assessing potential risk of drugs: the elusive target. Ann Intern Med. 1992;117(8):691–2.

    Article  CAS  Google Scholar 

  2. Beers MH, Ouslander JG, Rollingher I, et al. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med. 1991;151(9):1825–32.

    Article  CAS  Google Scholar 

  3. Stuck AE, Beers MH, Steiner A, et al. Inappropriate medication use in community-residing older persons. Arch Intern Med. 1994;154(19):2195–200.

    Article  CAS  Google Scholar 

  4. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: an update. Arch Intern Med. 1997;157(14):1531–6.

    Article  CAS  Google Scholar 

  5. Fick DM, Cooper JW, Wade WE, et al. Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003;163(22):2716–24.

    Article  Google Scholar 

  6. Fick D, Semla T, Beizer J, et al. American geriatrics society updated beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616–31.

    Article  Google Scholar 

  7. Samuel MJ. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–46.

    Article  Google Scholar 

  8. Hohl CM, Dankoff J, Colacone A, et al. Polypharmacy, adverse drug-related events, and potential adverse drug interactions in elderly patients presenting to an emergency department. Ann Emerg Med. 2001;38(6):666–71.

    Article  CAS  Google Scholar 

  9. Woodhouse KW, Wynne HA. Age-related changes in liver size and hepatic blood flow. Clin Pharmacokinet. 1988;15(5):287–94.

    Article  CAS  Google Scholar 

  10. Rowe JW, Andres R, Tobin JD, et al. The effect of age on creatinine clearance in men: a cross sectional and longitudinal study. J Gerontol. 1976;31(2):155–63.

    Article  CAS  Google Scholar 

  11. Passarelli MCG, Jacob-Filho W, Figueras A. Adverse drug reactions in an elderly hospitalised population: inappropriate prescription is a leading cause. Drugs Aging. 2005;22(9):767–77.

    Article  Google Scholar 

  12. Varallo FR, Capucho HC, Planeta CS, et al. Safety assessment of potentially inappropriate medications (PIM) use in older people and the factors associated with hospital admission. J Pharm Pharm Sci. 2011;14(2):283–90.

    Article  Google Scholar 

  13. Fu AZ, Jiang JZ, Reeves JH, et al. Potentially inappropriate medication use and healthcare expenditures in the US community-dwelling elderly. Med Care. 2007;45(5):472–6.

    Article  Google Scholar 

  14. Fick DM, Mion LC, Beerss MH, et al. Health outcomes associated with potentially inappropriate medication use in older adults. Res Nurs Health. 2008;31(1):42–51.

    Article  Google Scholar 

  15. The 2019 American Geriatirics Soceity Beers Criteria® update expert panel, American Geriatrics Society 2019 updated AGS Beerss criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–94.

  16. Ha WC, Oh SJ, Kim JH, et al. Severe hypoglycemia is a serious complication and becoming an economic burden in diabetes. Diabetes Metab J. 2012;36(4):280–4.

    Article  Google Scholar 

  17. Holstein A, Egberts EH. Risk of hypoglycaemia with oral antidiabetic agents in patients with type 2 diabetes. Exp Clin Endocrinol Diabetes. 2003;111(7):405–14.

    Article  CAS  Google Scholar 

  18. Østbye T, Kristjansson B, Hill G, et al. Prevalence and predictors of depression in elderly Canadians: the Canadian study of health and aging. Chronic Dis Can. 2005;26(4):93–9.

    PubMed  Google Scholar 

  19. Anderson IM. Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord. 2000;58(1):19–36.

    Article  CAS  Google Scholar 

  20. Eom CS, Lee HK, Ye S, et al. Use of selective serotonin reuptake inhibitors and risk of fracture: a systematic review and meta-analysis. J Bone Miner Res. 2012;27(5):1186–95.

    Article  CAS  Google Scholar 

  21. Ho KKL, Pinsky JL, Kannel WB, et al. The epidemiology of heart failure: the Framingham study. J Am Coll Cardiol. 1993;22(4):6A–13A.

    Article  CAS  Google Scholar 

  22. Fournier J-P, Yin H, Nessim SJ, et al. Tramadol for noncancer pain and the risk of hyponatremia. Am J Med. 2015;128(4):418–25.

    Article  CAS  Google Scholar 

  23. Hunter R. Tramadol and hyponatraemia. Aust Prescr. 2004;27(4):97.

    Article  Google Scholar 

  24. Udy A, Deacy N, Barnes D, et al. Tramadol-induced hyponatraemia following unicompartmental knee replacement surgery. Anaesthesia. 2005;60(8):814–6.

    Article  CAS  Google Scholar 

  25. Le Berre J-P, Desramé J, Lecoules S, et al. Hyponatremia due to tramdol [in French]. Rev Med Intern. 2007;28(12):888–9.

    Article  Google Scholar 

  26. Cummings JL, Lyketsos CG, Peskind ER, et al. Effect of dextromethorphan-quinidine on agitation in patients with alzheimer disease dementia: a randomized clinical trial. JAMA. 2015;314(12):1242–54.

    Article  CAS  Google Scholar 

  27. Antoniou T, Gomes T, Juurlink DN, et al. Trimethoprim-sulfamethoxazole–induced hyperkalemia in patients receiving inhibitors of the renin-angiotensin system: a population-based study. Arch Intern Med. 2010;170(12):1045–9.

    Article  CAS  Google Scholar 

  28. Perazella MA, Mahnensmith RL. Trimethoprim-sulfamethoxazole: hyperkalemia is an important complication regardless of dose. Clin Nephrol. 1996;46(3):187–92.

    CAS  PubMed  Google Scholar 

  29. Weir MA, Juurlink DN, Gomes T, et al. Beta-blockers, trimethoprim-sulfamethoxazole, and the risk of hyperkalemia requiring hospitalization in the elderly: a nested case-control study. Clin J Am Soc Nephrol. 2010;5(9):1544–51.

    Article  CAS  Google Scholar 

  30. Antoniou T, Gomes T, Mamdani MM, et al. Trimethoprim-sulfamethoxazole induced hyperkalaemia in elderly patients receiving spironolactone: nested case-control study. BMJ. 2011;343:d5228.

    Article  Google Scholar 

  31. Ho JMW, Juurlink DN. Considerations when prescribing trimethoprim–sulfamethoxazole. CMAJ. 2011;183(16):1851–8.

    Article  Google Scholar 

  32. American Geriatrics Society Expert Panel on Person-Centered Care. Person-centered care: a definition and essential elements. J Am Geriatr Soc. 2016;64(1):15–8.

    Article  Google Scholar 

Download references

Acknowledgements

The authors are thankful to Baba Farid University of Health Science, Faridkot, Punjab, India for providing the authors with all the necessary facilities and timely guidance.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Department of Pharmacy Practice, I S F College of Pharmacy, Moga, Punjab, India

    Rishabh Sharma

  2. Multi-Disciplinary Research Unit, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India

    Malika Arora

  3. Department of Medicine, Guru Gobind Singh Medical Hospital, Faridkot, Punjab, India

    Ravinder Garg

  4. University Centre of Excellence in Research, Baba Farid University of Health Sciences, Faridkot, Punjab, India

    Parveen Bansal

Authors
  1. Rishabh Sharma
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  2. Malika Arora
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  3. Ravinder Garg
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  4. Parveen Bansal
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Contributions

Malika Arora and Parveen Bansal were responsible for the concept and design of this study. Rishabh Sharma and Ravinder Garg collected data and Rishabh Sharma and Malika Arora interpreted data. Rishabh Sharma, Malika Arora and Parveen Bansal prepared the manuscript.

Corresponding author

Correspondence to Parveen Bansal.

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The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Sharma, R., Arora, M., Garg, R. et al. A closer look at the 2019 Beers criteria. Drugs Ther Perspect 36, 116–122 (2020). https://doi.org/10.1007/s40267-019-00704-x

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