How to Use the American Geriatrics Society 2015 Beers Criteria—A Guide for Patients, Clinicians, Health Systems, and Payors

Abstract

The Beers Criteria are a valuable tool for clinical care and quality improvement, but may be misinterpreted and implemented in ways that cause unintended harms. In this paper, we describe the intended role of the 2015 AGS Beers Criteria, and provide guidance on how they should be used by patients, clinicians, health systems, and payors. A key theme underlying these recommendations is to use common sense and clinical judgment in applying the 2015 AGS Beers Criteria, and to remain mindful of nuances in the criteria. The criteria serve as a “warning light” to identify medications that have an unfavorable balance of benefits and harms in many older adults, particularly when compared to pharmacologic and non-pharmacologic alternatives. However, there are situations in which use of medications included in the criteria can be appropriate. As such, the 2015 AGS Beers Criteria work best not only when they identify potentially inappropriate medications, but when they educate clinicians and patients about the reasons those medications are included and the situations in which their use may be more or less problematic. The criteria are designed to support, rather than supplant, good clinical judgment.

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

“…A companion article published to the 2015 updated AGS Beers Criteria®, entitled “How to Use the Beers Criteria: A Guide for Patients, Clinicians, Health Systems, and Payors,” remains an important guide for using the AGS Beers Criteria®. It reminds clinicians that medications listed in the Criteria are potentially inappropriate, rather than definitely inappropriate for all older adults, and encourages users to read the rationale and recommendation statements for each medication to avoid because these statements provide important guidance . Moreover, the criteria should not be interpreted as giving license to steer patients away from PIMs to even worse choices.…”

“…We hope that the criteria will be used thoughtfully and widely. To facilitate this process, we encourage healthcare professionals, patients, payors, and health systems to access resources with information on the criteria, including patient‐oriented information on the Health in Aging Foundation website (http://www.healthinaging.org/medications-older-adults/) and guidance for all on the proper use of the criteria . Ongoing support from AGS will facilitate future evidence‐based updates, keeping the AGS Beers Criteria® useful, relevant, and a valuable tool for improving the health and well‐being of older adults.…”

“…Despite past and current efforts to translate the criteria into practice, some controversy and myths about their use in practice and policy continue to prevail. The panel addressed these concerns and myths by writing a companion article to the 2015 update of the AGS Beers Criteria® and an updated 2019 short piece, which remains the best way to advise patients, providers, and health systems on how to use (and not use) the 2019 AGS Beers Criteria® …”

Perspectives from Geriatric In-patients with Heart Failure, and their Caregivers, on Gaps in Care Quality

“…Medications upon admission and DC, as well as medications found on the Beer’s list (11) were documented. Echocardiogram reports, including ejection fraction and diastolic dysfunction, were recorded.…”

Using Wisely: A Reminder on the Proper Use of the American Geriatrics Society Beers Criteria®

“…These criteria, developed through a modified Delphi consensus process, is no exception to the potential for promises and pitfalls. To promote optimal use of the criteria, in 2015 a subgroup of the update expert panel published a companion paper, “How to Use the American Geriatrics Society 2015 Beers Criteria®—A Guide for Patients, Clinicians, Health Systems, and Payors.” Coincident with the release of the current update, we wish to remind readers of the seven key principles articulated in that companion paper (Table ). These principles are intended to guide use of the AGS Beers Criteria® in a way that maximizes their benefits while minimizing unintended harms, and reflects the spirit in which they were developed.…”