Polypharmacy III

This is #3 in the Polypharmacy series about why be concerned with seniors taking so many pills: What is Beers List of Potentially Inappropriate Medications


What is Beers List and why is it important?
Beers List, or Beers Criteria (named after geriatrician Dr. Beers), describes drugs seniors should avoid because the potential for harm outweighs any potential benefit.
 
The drugs listed are associated with poorer outcomes:  increased hospitalizations and death rates; more risk of falling, fractures, confusion, and depression; and increased need for assistance in ADL’s [Activities of Daily Living – dressing, toileting, walking, eating, bathing].  Medicare and the States use the List to monitor quality of care in nursing homes:  patients on any one of these must have documentation justifying why.

What drugs are included?
The List includes 53 medications or drug classes, divided into three categories: 
1) drugs to avoid in all older adults;
2) those to avoid if you have certain diseases that the drugs can make worse; and
3) drugs which may be used but only with great caution.

The List only suggests drugs that are “potentially inappropriate” because there may be situations where (a) one is needed and no other drug has worked, or (b) someone’s taken it for years and has had minimal or tolerable side-effects.  The decision to take the drug is one shared between patient and doctor.

The List is important:  knowing possible side-effects can help avoid high-risk drugs; and if there is a bothersome symptom, it can guide which drugs to stop first—rather than add another prescription to treat the side-effect.  If your health depends on the drug, your physician may be able to prescribe an alternative with fewer side-effects. 

The next three articles will highlight a sample of drugs in each of the three categories.