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American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
Open accessAbstract
Potentially inappropriate medications (PIMs) continue to be prescribed and used as first-line treatment for the most vulnerable of older adults, despite evidence of poor outcomes from the use of PIMs in older adults. PIMs now form an integral part of policy and practice and are incorporated into several quality measures. The specific aim of this project was to update the previous Beers Criteria using a comprehensive, systematic review and grading of the evidence on drug-related problems and adverse drug events (ADEs) in older adults. This was accomplished through the support of The American Geriatrics Society (AGS) and the work of an interdisciplinary panel of 11 experts in geriatric care and pharmacotherapy who applied a modified Delphi method to the systematic review and grading to reach consensus on the updated 2012 AGS Beers Criteria. Fifty-three medications or medication classes encompass the final updated Criteria, which are divided into three categories: potentially inappropriate medications and classes to avoid in older adults, potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes that the drugs listed can exacerbate, and finally medications to be used with caution in older adults. This update has much strength, including the use of an evidence-based approach using the Institute of Medicine standards and the development of a partnership to regularly update the Criteria. Thoughtful application of the Criteria will allow for (a) closer monitoring of drug use, (b) application of real-time e-prescribing and interventions to decrease ADEs in older adults, and (c) better patient outcomes.
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“For example, diphenhydramine, often taken as an over-the-counter drug combination with acetaminophen for sleep and pain relief; other sedative-hypnotics; and medications for anxiety (eg, benzodiazepines) or urinary incontinence (antimuscarinic) are relatively contraindicated in elderly and cognitively vulnerable persons.44,58”
From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [44]
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“The American Geriatrics Society (22) considers use of paroxetine for patients with impaired cognition to be potentially inappropriate because of the drug's strong anticholinergic properties.”
From Risk of Dementia Among Elderly Nursing Home Patients Using Paroxetine and Other Selective Serotonin Reuptake Inhibitors (2015) · cites this paper as [22]
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“Anticholinergic use was defined as those medications deemed to have strong anticholinergic activity as per consensus by an expert panel of health care professionals.8,13”
From Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study (2015) · cites this paper as [8]
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“We used the approach of Gray et al,11 which included drugs identified as having strong anticholinergic properties by the American Geriatrics Society 2012 Beers Criteria Update Expert Panel.14”
From Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study (2019) · cites this paper as [14]
In the citing paper
“The recently published 2012 Beers list of prohibited medications in long-term care facilities speci fi cally lists insulin sliding scales and glyburide as treatment modalities that should be avoided (61).”
From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [61]
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“Glyburide has the highest hypoglycemia risk and should not be prescribed for older adults98.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [98]
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Metadata
- Authors
- The American Geriatrics Society 2012 Beers Criteria Update Expert Panel
- Affiliations
- American Geriatrics Society (US)
- Corresponding author
- The American Geriatrics Society 2012 Beers Criteria Update Expert Panel
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2012-02-29
- Volume
- 60
- Issue
- 4
- Pages
- 616-631
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- PMC
- PMC3571677
- OpenAlex
- W2257575319
- Cited by
- 2,578
- References
- 44
- Citations by year
- 2026: 20 · 2025: 37 · 2024: 37 · 2023: 60 · 2022: 54 · 2021: 256 · 2020: 298 · 2019: 194 · 2018: 163 · 2017: 213 · 2016: 300 · 2015: 344 · 2014: 305 · 2013: 207 · 2012: 86
- FWCI
- 25.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5k07ag033174-05)
- Agency for Healthcare Research and Quality (R01HS017695, R01HS018721)
- National Institute on Aging (R01AG027017, K07‐AG033174, R01AG034056, P30AG024827, T32AG021885)
- National Institute of Nursing Research (R01NR010135, R01NR011042, R01NR012242)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Health Sciences › Health Professions › Pharmacy › Pharmacy and Medical Practices
- Keywords
- Beers criteria, potentially inappropriate medications, older adults, drug-related problems, adverse drug reactions, drug safety, Delphi consensus, level of evidence, quality metrics
- MeSH terms
- Aged, Geriatrics, Humans, Medication Errors, Practice Patterns, Physicians', Drug Prescriptions, Societies, Medical, United States
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