The Beers List: Medications Seniors Should Use with Caution

The Beers list (the AGS Beers Criteria) is used to help doctors reduce medication side effects or problems in senior patients.

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  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.

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.

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

 

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 part of 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 so you catch potential issues early.

At the end of the day, the doctor is the medical expert. But to get the best care for your older adult, it’s necessary for you to understand their health conditions and why specific treatments are right for their situation. 

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

 

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By DailyCaring Editorial Team

 

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


14 Comments

  • Reply August 25, 2021

    gerard

    Its disappointing that the list is not available publicly, it raises the question of what are they trying to hide? My guess is that it raised too many eyebrows and caused controversy, so now they hide it from the public.

    • Reply August 25, 2021

      DailyCaring

      It’s possible that they no longer publish the list for the general public because it’s a tool intended for doctors to use. People without a medical background aren’t able to properly use the information, which could potentially cause problems.

  • Reply August 25, 2021

    robert

    The list should be publicly available.I found out that my mother was taking one of these medications at the memory care facility where she lives by asking a geriatric pharmacist to review the list of medications given to her there and without her review of her medical record she would be taking this medication still

    • Reply August 25, 2021

      DailyCaring

      It’s great that you had her doctor review all her medications to determine which ones were doing her more good than harm. It’s a good idea for a doctor to review someone’s medications regularly to be sure that all are still needed and still effective.

  • Reply April 1, 2021

    Susan Bland

    The Beers List should be available to the public. It would help caregivers so they could ask about potential drug interactions and the effects of certain medications. When an elderly patient is taking 5 or more drugs a day, the caregivers need all the help they can get to ask intelligent and pertinent questions.

    • Reply April 6, 2021

      DailyCaring

      The Beers List used to be available to the public. We don’t know why this has changed. The next best thing would be to ask your older adult’s doctor about it when you ask them to review your older adult’s current medications.

  • 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.

      • Reply July 29, 2020

        Phil Benson

        What is on the beers list?

        • Reply August 17, 2020

          DailyCaring

          The Beers List is no longer available publicly, so we don’t know which medications are on it. It’s helpful to be aware that this list exists and that medications can affect different age groups in different ways.

          Medical doctors have access to this information and would be the best people to advise patients on which medications are recommended for their specific health situation.

        • Reply August 26, 2021

          Sarah crowe

          What is on the Beers List?

          • August 26, 2021

            DailyCaring

            The AGS Beers Criteria isn’t publicly available. It’s a resource for medical professionals (explained in the 5th section in the above article).

            To find out about your older adult’s specific medications, speak with their doctor to request a full medication review to make sure all their current medications and supplements are currently needed and that the benefits of each outweigh the potential risks.

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