The Beers List: Medications Seniors Should Use with Caution

medications seniors should avoid

American Geriatrics Society cautions seniors about certain drugs

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 so many seniors take 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, the Beers list) and is for doctors to use when they’re 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.

We 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.




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What is the Beers list?

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.

It’s now informally referred to as the Beers list and is used to help doctors improve care for older patients. 

In 2019, it’s been updated and reviewed by the AGS and a panel of experts in geriatric care and pharmacotherapy.

The 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

 

Why would a doctor need the Beers list?

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.

But doctors who don’t specialize in treating older adults usually see more younger patients than old.

So, 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 the problem, not the solution.

 

Why would a doctor prescribe a drug that’s on the Beers list?

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’s on the list.




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How caregivers can use the Beers list

The AGS no longer makes the Beers list publicly available, but knowing that it exists can help when you speak with your older adult’s doctor.

When their doctor does a full medication review or prescribes a new medication, it’s a great opportunity to ask if any of their medications are on the Beers list.

If they are, you could ask if that’s the best option or if an alternative might be better or less risky.

You’re not trying to second guess the doctor. Your goal is to get a better understanding of why a specific drug is needed and what the potential side effects or interactions are.

At the end of the day, the doctor is the expert. But to get the best care for your older adult, it’s necessary to understand their condition and why a specific treatment is right for their situation. 

And as their health advocate, you have every right to ask for the information you need.

 

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By DailyCaring Editorial Team
Image: AcuPharm

 

This article wasn’t sponsored and doesn’t contain affiliate links. For more information, see How We Make Money.


4 Comments

  • Reply May 17, 2019

    John Sloan Jr, MD (certified in Geriatric Medicine)

    Sometimes the Beers list is used by insurance companies and others to promote safety but arbitrarily using age 65 as “elderly” is insulting and demeaning . The list is for doctors use to help evaluate which drugs may cause problems in a specific patient not a tool to use to teat older adults like children

  • Reply March 22, 2018

    Linda S

    Thank you so much for the helpful link. A physician just put my 82 year old mother-in-law, who has moderate dementia, on Temazepam, which increases cogntive impairment, delirium, falls, etc and is subject to abuse. For a ‘sleep disorder’ she complained about. While the solution is simple, don’t sleep in the day, don’t drink caffeinated products after 5! No pills necessary.

    • Reply March 23, 2018

      DailyCaring

      So glad this is helpful! It’s great that you were able to find out that this medication didn’t work for your mother-in-law. It’s also great that you were able to find a non-drug solution that works for her. Sometimes medication is needed and sometimes it does more harm than good, like in her case.

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