The Origin of the Beers List
The first Beers Criteria were published in 1991 by geriatrician Dr. Mark H. Beers and his colleagues in the Archives of Internal Medicine. Their work aimed to address the issue of inappropriate medication prescribing for older adults, particularly those in nursing homes. Dr. Beers' research highlighted a lack of evidence regarding the safety of certain medications in the elderly, leading him to lead a consensus panel using the Delphi method to create the initial list.
Evolution and Updates by the American Geriatrics Society (AGS)
While Dr. Beers initiated the criteria, the American Geriatrics Society (AGS) has been instrumental in its continued development and widespread use. The AGS took over the criteria's maintenance and regular updating in 2011, renaming it the AGS Beers Criteria®. An interprofessional panel of experts regularly revises the list based on current clinical evidence. For example, the 2023 update incorporated findings from over 1,500 studies. The AGS's involvement has expanded the criteria's applicability beyond nursing homes to encompass all care settings.
The Purpose and Structure of the Beers Criteria
The Beers Criteria provide guidance for healthcare professionals to enhance medication safety for individuals aged 65 and older. They aim to minimize adverse drug events, which can significantly affect the health and well-being of seniors. The list identifies medications that are potentially inappropriate, and clinical judgment is always necessary when making prescribing decisions.
The criteria are structured into five main categories:
- Medications to avoid in most older adults
- Medications to avoid among people with specific health conditions
- Medications to use with caution
- Medication interactions
- Medications with dosage adjustments based on kidney function
Comparing Early and Modern Beers Criteria
A comparison between the original 1991 criteria and modern versions, like the 2023 AGS Beers Criteria®, highlights shifts in authorship, scope, update frequency, review process, included drug classes, and overall purpose. For a detailed table comparing these features, refer to the {Link: American Geriatrics Society website https://www.americangeriatrics.org/media-center/news/many-older-adults-take-multiple-medications-updated-ags-beers-criteriar-will-help}.
The Impact of the Beers Criteria
The Beers list has significantly influenced geriatric care by promoting safer prescribing. It is a fundamental tool used for improving patient safety, educating professionals and patients, evaluating care quality, and informing policy.
To complement the Beers list, practices like medication reconciliation and deprescribing are vital for managing multiple medications and ensuring appropriate use in older adults. The AGS's ongoing updates ensure the criteria remain a valuable resource for optimizing senior health outcomes.
For further details on the latest criteria, refer to the American Geriatrics Society's official publications.
Conclusion
Dr. Mark H. Beers laid the groundwork for the Beers list in 1991, establishing a key resource for medication safety in older adults. Since 2011, the American Geriatrics Society has continued this work through regular updates and expansions, transforming it from a guideline for nursing homes to a comprehensive tool for all geriatric care. Understanding its history and purpose is essential for healthcare providers and patients to make informed decisions for safer and more effective medication management in seniors.
