Older adults may be at increased risk for problems related to drug side effects or interactions. That’s because older bodies process medications differently. And also because many seniors are taking multiple drugs for multiple health conditions. To reduce risk, the American Geriatrics Society (AGS) maintains a list of medications that are more likely to cause problems for seniors. It’s called the AGS Beers Criteria (informally called the Beers list) and is for doctors to use as a reference when prescribing drugs to patients who are 65 or older. For caregivers, being more informed about these medications means you’ll be able to ask better questions and be more aware of potential problems. I will explain what the Beers list is, why a doctor would need it, why a doctor might prescribe a drug on the list, and how the list can help with caregiving.
In 1991, Dr. Mark Beers published a paper with a list of medications that were considered to be not appropriate for people living in long-term care facilities – mostly older adults. This is now called the AGS Beers Criteria and informally referred to as the Beers list. It’s used to help doctors improve care for older patients. It’s been updated and reviewed by the AGS in 2019 by a panel of experts in geriatric care and pharmacotherapy.
The Beers list puts medications into five categories:
- Medications and types of medications that are “potentially inappropriate” for older people
- Medications that are potentially inappropriate for older adults with certain common health problems
- Types of medications that should be used with caution in older adults
- Medication combinations that may result in harmful ”drug-drug” interactions
- Medications that should be avoided or have their dose changed in people with poor kidney function
Geriatricians (geriatric doctors) have the most experience treating older patients and are more familiar with drugs commonly used by seniors. They’re also likely to be familiar with the Beers list and have a better idea of what medications do and don’t work well for seniors and what combinations could be problematic; however, doctors who don’tspecialize in treating older adults usually see more younger patients than old. As a result, they may have never prescribed certain medications for conditions common in older adults. They’re also less likely to have experience with side effects or interactions that are more common in seniors. This lack of experience with medication effects on older bodies can be a problem if a drug side effect or interaction causes a problem for your older adult. They might not realize that a medication could be part of the problem, not the solution.
It’s important to remember that doctors should use the Beers list as a reference when prescribing medication for an older adult, but they shouldn’t base their decisions completely on the list. That’s because the Beers list can’t apply to all situations or specific health conditions for each unique person. It also doesn’t take into account the circumstances for people who are receiving palliative or hospice care. So it’s not “wrong” for a doctor to prescribe a drug that’s on the Beers list. There may be a good reason. Each person responds differently to medication and in some cases, the best drug for their specific situation may be one that is on the list. By having knowledge around this list and how drugs are classified is a great first step to understanding your elder loved one’s medications. Don’t be afraid to ask their physician tough questions and as a team, you can help shape a safe environment with your loved one’s pharmacologic regimen. Feel free to reach out to me directly if you are in need of resources or have questions about this subject. Amada Senior Care provides non-medical in home care services for seniors or adults with disabilities in the comfort of their own home. Our office number is 615-933-7494. Thank you and God Bless.
Kevin B. Fehr, CSA, Certified Senior Advisor President & CEO, Amada Senior Care