![]() |
Dr. Mark Beers |
According to the new draft guidelines for the new AGS Updated Beers Criteria the answer for these questions and for many other medications is a clear "avoid". Now is your chance though to both read these draft guidelines and to give your opinion before they are finalized (click here for the AGS site).
Why spend your time doing this?
It’s been two decades since the original Beers Criteria was published by the late Dr. Mark Beers. The original list comprised of drugs that were potentially inappropriate for elderly patients residing in nursing homes but have been subsequently revised to include elderly patients in all settings.
The drugs listed in the Beers Criteria have side effects that were thought to be far more harmful in elderly patients than any potential therapeutic benefit. They have been used by health care providers to help guide prescribing, and educators like myself to teach what drugs to avoid in the elderly. Importantly though, other entities like CMS, the National Committee on Quality Assurance (NCQA), and Pharmaceutical Quality Alliance (PQA) are all interested in using the criteria as part of their quality measures.
In 2011, AGS convened an expert panel that reviewed available evidence as a part of its process for revising these guidelines. These updated criteria address three primary areas:
- Criteria for Potentially Inappropriate Medication Use in Older Persons: Independent of Diagnoses or Conditions
- Criteria for Potentially Inappropriate Medication Use in Older Persons Due To Drug – Disease/ Syndrome Interaction
- Criteria for Potentially Inappropriate Medication Use in Older Persons: Drugs to be used with caution
So now is the time to comment before these guidelines are potentially used as a quality measure for your own practice. The draft AGS Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (AGS Beers Criteria) will be available on the America Geriatrics Society (AGS) website for public comment until 5:00pm ET on November, 28, 2011.
by: Eric Widera
Comments
There is a general blasting of NSAIDs for GI toxicity, without note that some (like nabumetone) seem to be considerably safer.
I've got some homework to do in a couple of cases. The SSRI caution in patients who fall is new to me. I've got to try to find the evidence against H2RAs in delirium. If someone could pass along a reference, that would be great. (And is the caution against using them only in current delirium, or does this mean that I should avoid them for some number of months out after an episode of delirium?) My recollection is that I was taught that cimetidine and IV routes were problematic, but oral ranitidine is OK. Perhaps one of those areas where medicine changes and I haven't kept up.