The 2012 Update of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

By: Shannon Tellier

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Medication related problems can be reduced in older adults if the Beers Criteria were utilized by health care professionals. The criteria serves as a guideline to identify potentially inappropriate medications (PIMs) that should be avoided in the elderly population, but it should not replace clinical judgment. This 2012 update includes a systematic literature review, use of an expert panel, grading the strength of evidence, and three categories of PIMs. The categories include PIMs and classes to avoid in older adults, PIMs and classes to avoid in older adults with certain diseases and syndromes that the drugs can exacerbate, and medications to be used in caution in older adults. The 2012 update to the Beers Criteria is necessary due to new medication, recalled medication, and insufficient or new evidence evaluated by the panel.

As pharmacists and pharmacy students, it is important to be aware of classes of medications that have potential to harm older adults. Additions to the 2012 update include megestrol (Megace®), glyburide (DiaBeta®, Glynase®), sliding-scale insulin, thiazolidinediones or glitazones with heart failure, acetylcholinesterase inhibitors with history of syncope, and selective serotonin reuptake inhibitors with falls and fractures. Due to insufficient evidence, new evidence, or removal from the U.S market, nineteen medication and medication classes have been removed from the 2012 update. Some of the dropped medications include propoxyphene and combination products, daily fluoxetine (Paxil ®), and ferrous sulfate >325 mg/day. A combination of clinical judgment and familiarity with the Beers Criteria by all health care professionals will help reduce adverse drug events in older adults.

Read the 2012 Beers Criteria update at: http://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2012.03923.x/pdf