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Patient-specific Beers Criteria Tool

This tool can be used to create a patient-specific report of medications from the Beers criteria based on a patient's current conditions and drug therapy.  A printable report is also available.

Potentially Inappropriate Medication Use in Older Adults

Check all groups the patient is receiving: led

1st generation antihistamines    Antiparkinsonian agents   Antispasmodics
Antithrombotics -Dipyridamole, Ticlopidine  
Anti-infective - Nitrofurantoin 
Cardiovascular agents -
alpha-1 blockers, Central alpha agonists, amiodarone, digoxin, etc
Central nervous system drugs -
Antidepressants, Barbiturates, Benzodiazepines, Nonbenzodiazepine hypnotics, or Ergoloid mesylates 
Endocrine drugs -
Androgens,Estrogens, GH, SS insulin, Long-acting Sulfonylureas
Gastrointestinal drugs-
Metoclopramide, Mineral oil, given orally, Proton-pump inhibitors
Pain medications - NSAIDs , Pentazocine, Skeletal muscle relaxants
  Genitourinary - Desmopressin

Potentially Inappropriate Medication Use in Older Adults Due to Drug-Disease or Drug-Syndrome Interactions That May Exacerbate the Disease or Syndrome

Check all condition(s) that are present in the patient: led

Heart failure
Syncope
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Chronic seizures or epilepsy
Delirium
Dementia or cognitive impairment
History of falls or fractures
Insomnia
Parkinson disease
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History of gastric or duodenal ulcers
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Chronic kidney disease Stages IV or less (creatinine clearance <30 mL/min)
Urinary incontinence (all types) in women
Lower urinary tract symptoms, benign prostatic hyperplasia

Potentially Inappropriate Medications to Be Used with Caution in Older Adults

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Renal Insufficiency - Medications That Should Be Avoided or Have Their Dosage Reduced with Varying Levels of Kidney Function in Older Adults

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Drugs with Strong Anticholinergic Properties

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Background Info

The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly referred to as the Beers List,  are criteria used by healthcare professionals to monitor and improve the safety of prescribing medications in patients over 65 years of age.  The guidelines focus on eliminating medications that have greater risks than perceived benefits. In some cases, the medications are completely unnecessary and are part of a complex prescribing history (prescribing cascade) that requires the addition of new medications to counteract a growing list of side effects from the current list of medications.

The criteria includes lists of medications from multiple drug classes that are either inappropriate, or potentially inappropriate if certain co-existing condition(s) are present.  It also includes a list of medications that should be avoided in patients with renal insufficiency.
The 2015 AGS Beers Criteria are applicable to all older adults with the exclusion of those in palliative and hospice care.

All of the guidelines were created following an evidence-based approach using the Institute of Medicine standards.  Following the guidelines should provide the following benefits:

  1. Decrease the risk of possible adverse effects.
  2. Improve health outcomes in older adults including a lower risk of falls, confusion, cognitive impairment and mortality.
  3. Eliminate or reduce the number of inappropriate medications especially those tied to a 'prescribing cascade.'

References

American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc 63:2227-2246, 2015.

Disclaimer

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
 

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