Beers criteria

What are Beers criteria?

Beers criteria define medications that generally should be avoided in ambulatory elderly patients, doses or frequencies of administration that should not be exceeded, and medications that should be avoided in older persons known to have any of several common conditions.

History

The criteria were originally developed using a formal consensus process for combining reviews of the evidence with expert input.

Inappropriate use of medications

The criteria for inappropriate use address commonly used categories of medications such as sedative-hypnotics, antidepressants, antipsychotics, antihypertensives, nonsteroidal anti-inflammatory agents, oral hypoglycemics, analgesics, dementia treatments, platelet inhibitors, histamine-2 blockers, antibiotics, decongestants, iron supplements, muscle relaxants, gastrointestinal antispasmodics, and antiemetics.

Guide for clinical practice

• The criteria were intended to guide clinical practice, but also to inform quality assurance review and health services research.
• Most would agree that prescriptions for medications deemed inappropriate according to Beers criteria represent poor quality care.
• Unfortunately, harm does not only occur from receipt of these inappropriately prescribed medications.
• In one comprehensive national study of medication-related emergency department visits for elderly patients, most problems involved common and important medications not considered inappropriate according to the Beers criteria—principally, oral anticoagulants (e.g., warfarin), antidiabetic agents (e.g., insulin), and antiplatelet agents (aspirin and clopidogrel).