Many older adults take multiple medications; an updated AGS Beers Criteria® will help ensure they are appropriate

New York (May 4, 2023) — Today, the American Geriatrics Society (AGS) released the 2023 update to the AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults (DOI: 10.1111/jgs.18372). The AGS Beers Criteria® serves as a comprehensive list of medications that older people should potentially avoid or consider using with caution because they often present unnecessary risks for this population. Given that, according to the National Center for Health Statistics, United States (NCHSUS), more than 88% of older people use at least one prescription and more than 66% use three or more in any given month, the AGS Beers Criteria® are  an important clinical, educational, c and quality assurance tool for clinicians across disciplines and the healthcare system as a whole.

“Medications have a vital role to play in helping us to remain healthy, active, and engaged in our communities,” said Donna M. Fick, PhD, GCNS-BC, FGSA, FAAN, AGSF, AGS President-elect and a member of the AGS Beers Criteria® Expert Panel. “The 2023 AGS Beers Criteria® is based on the best available evidence and supports person-centered decision-making that takes into account what matters to an older person, considers both drug and non-drug approaches to care, and is focused on maximizing health while minimizing unnecessary risk.”

Though not an exhaustive catalogue of inappropriate treatments, the five lists included in the AGS Beers Criteria® describe particular medications where the best available evidence suggests they should be:

1. Avoided by most older adults (outside of hospice and palliative care settings);
2. Avoided by older adults with specific health conditions;
3. Used with caution because of the potential for harmful side effects; or    
4. Avoided in combination with other treatments because of the risk for harmful “drug-drug” interactions; or
5. Dosed differently or avoided among older adults with reduced kidney function, which impacts how the body processes medicine.

First developed by the late Mark Beers, MD, and colleagues in 1991, the AGS took over maintenance and updating of the AGS Beers Criteria® in 2011. For the 2023 update, an expert panel reviewed more than 1,500 clinical trials and research studies published between 2017 and 2022. The resulting 2023 AGS Beers Criteria® include: 

• Over three dozen individual medications or medication classes to avoid for most older people. 
• 40+ medications or medication classes to use with caution or avoid when someone lives with certain diseases or conditions. 

The expert panel also moved several medications to different categories or revised guidance based on new evidence. To simplify and increase usability of the five lists comprising the criteria, the panel moved a number of medications to a separate list given that they have low usage or are no longer available in the United States. The panel still considers these medications as being potentially inappropriate for use in older adults in alignment with the 2019 criteria. 

“The AGS Beers Criteria® offers guidance about potentially harmful treatments for all of us as we age, supporting clinicians, patients, and caregivers to choose the safest, most effective treatment when making decisions that are individualized to what matters to the person. Our goal is to improve drug therapy and outcomes by identifying and reducing the prescribing of potentially inappropriate medications in older adults,” noted Todd Semla, MS, PharmD, BCGP, FCCP, AGSF, a co-chair of the 2023 AGS Beers Criteria® expert panel. “The AGS Beers Criteria® should never solely dictate how medications are prescribed or be used to justify restricting health coverage,” he added. “We encourage older adults who see one of their drugs listed on the AGS Beers Criteria to speak with their clinician about an alternative."

Published in its entirety in the Journal of the American Geriatrics Society (DOI: 10.1111/jgs.18372) the AGS Beers Criteria® is also available as a mobile app and as a pocket reference card. Both are designed to meet the needs of busy clinicians practicing in a variety of settings and are available from GeriatricsCareOnline.org. The AGS is committed to bringing the expertise of geriatrics health professionals to the public and lay versions of the Beers Criteria® as well as tools to aid older adults and caregivers in understanding what medications are potentially inappropriate are available for free from https://www.healthinaging.org/HealthinAging.org).

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About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Our 6,000+ members include geriatricians, geriatrics nurse practitioners, social workers, family practitioners, physician assistants, pharmacists, and internists who are pioneers in advanced illness care for older individuals, with a focus on championing interprofessional teams, eliciting personal care goals, and treating older people as whole persons. AGS believes in a just society, one where we all are supported by and able to contribute to communities where ageism, ableism, classism, homophobia, racism, sexism, xenophobia, and other forms of bias and discrimination no longer impact healthcare access, quality, and outcomes for older adults and their caregivers. AGS advocates for policies and programs that support the health, independence, and quality of life of all of us as we age. AGS works across patient care, research, professional and public education, and public policy to improve the health, independence, and quality of life of all older people. For more information, visit AmericanGeriatrics.org.

About the Health in Aging Foundation
The Health in Aging Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly one million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit HealthinAgingFoundation.org.

About the AGS Annual Scientific Meeting
The AGS Annual Scientific Meeting is the premier educational event in geriatrics, providing the latest information on clinical care, research on aging, and innovative models of care delivery. More than 2,500 nurses, pharmacists, physicians, physician assistants, social workers, long-term care and managed care providers, healthcare administrators, and others will convene in Long Beach, CA, May 4-6, 2023 (pre-conference program on May 3), to advance geriatrics knowledge and skills through state-of-the-art educational sessions and research presentations. For more information, visit https://meeting.americangeriatrics.org/.