American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

Abstract

The 2015 American Geriatrics Society (AGS) Beers Criteria are presented. Like the 2012 AGS Beers Criteria, they include lists of potentially inappropriate medications to be avoided in older adults. New to the criteria are lists of select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug-drug interactions documented to be associated with harms in older adults. The specific aim was to have a 13-member interdisciplinary panel of experts in geriatric care and pharmacotherapy update the 2012 AGS Beers Criteria using a modified Delphi method to systematically review and grade the evidence and reach a consensus on each existing and new criterion. The process followed an evidence-based approach using Institute of Medicine standards. The 2015 AGS Beers Criteria are applicable to all older adults with the exclusion of those in palliative and hospice care. Careful application of the criteria by health professionals, consumers, payors, and health systems should lead to closer monitoring of drug use in older adults.

Potentially Inappropriate Medication Use Among Older Hospitalized Patients in a Brazilian General Hospital

“…These results demonstrate that hospitalized elderly may be at greater risk of ADRs such as constipation, orthostatic hypotension, sedation, walking difficulties, falls and fractures (18,19).…”

“…Pharmacotherapy is considered potentially inappropriate when the risks of its use outweigh its benefits (18)(19)(20).Exposure of the elderly population to this type of medication has been shown to be associated with increased morbidity and mortality, increased the frequency of health service use and higher occurrence of ADR (12,13,15,16,21,22).Studies have shown that the prescription of PIM to Brazilian elderly is commonplace in some different settings (23)(24)(25). However, the number of pharmacoepidemiological studies focusing on the Brazilian hospitalized elderly population during their hospital stay is small (26).…”

Medication appropriateness tool for co‐morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel

“…We anticipated that this project would generate a list of appropriate and inappropriate medications for managing co‐morbidities in dementia, similar to other existing explicit prescribing criteria in older people such as the Beers and STOPP/START criteria 60, 61. However, the expert responses to the Round 1 questions emphasised individualising treatment and the importance of reviewing treatments for co‐morbidities as the dementia progresses.…”

Spontaneous Resolution of Nitrofurantoin-Induced Chronic Pulmonary Toxicity Presenting with Respiratory Failure

“…The Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases recommend nitrofurantoin as one of the first line antibiotics in uncomplicated UTIs, given the low cost of therapy, efficacy as well as its positive impact on antimicrobial resistance patterns [1]. However, nitrofurantoin is also one of the most common drugs to be reported for a variety of pulmonary, hepatic and peripheral nervous system adverse effects [2][3][4]. The spectrum of pulmonary toxicities ranges from acute hypersensitivity reactions to chronic dose-dependent pathologies like chronic interstitial pneumonitis, fibrosis and organizing pneumonia [2][3][4].…”

“…However, nitrofurantoin is also one of the most common drugs to be reported for a variety of pulmonary, hepatic and peripheral nervous system adverse effects [2][3][4]. The spectrum of pulmonary toxicities ranges from acute hypersensitivity reactions to chronic dose-dependent pathologies like chronic interstitial pneumonitis, fibrosis and organizing pneumonia [2][3][4]. In view of these possible side effects and available alternative medicines, the American Geriatrics Society in a 2015 update listed nitrofurantoin as a "potentially inappropriate medication" for prolonged use in adults 65 years of age and older [4].…”