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Potentially inappropriate medications are drugs that pose a risk of causing adverse events. Many tools, such as the American Geriatrics Society Beers Criteria®, have been developed to assess potentially inappropriate medications in the geriatric population. The latest version of the AGS Beers Criteria® was revised in 2019 to assist practicing clinicians in outpatient, acute, and institutional settings. It includes medications evaluated in 5 main categories: drugs to avoid, drugs to use with caution, drug-drug interactions, medications to avoid in particular clinical situations, and dosage according to kidney function. This activity illustrates the main issues concerning inappropriate medication use in the geriatric population and highlights the interprofessional team's role in improving patient care. Objectives: Identify the importance of inappropriate medication use in the geriatric population and summarize the risks associated with inappropriate medication use. Evaluate the basis, utilization, advantages, and limitations of the AGS Beers Criteria. Assess relevant strategies to assess geriatric patients with potentially inappropriate medications. Communicate the interprofessional interventions for evaluating and preventing inappropriate medication use in older adults. Access free multiple choice questions on this topic.

Potentially inappropriate medications (PIM) can be defined as drugs that pose an increased risk of causing adverse events.[1] The American Geriatrics Society Beers Criteria® is a set of recommendations for avoiding PIMs in the geriatric population.[2] Initially published in 1991, the AGS Beers Criteria® has been periodically updated to provide more accurate and practical guidelines for healthcare providers.[3][4][1] The AGS Beers Criteria® is consistently revised by an interprofessional team utilizing an evidence-based approach.[3][5] The latest version of the AGS Beers Criteria® was written in 2019 to assist practicing clinicians in outpatient, acute, and institutional settings. It includes medications evaluated in 5 main categories: drugs to avoid, drugs to use with caution, drug-drug interactions, medications to avoid in particular clinical situations, and dosage according to kidney function.[3] The AGS Beers Criteria® is a guideline for practitioners to improve prescriptions, outcomes, and quality of care. Although this list is a comprehensive guide for clinicians, nurses, pharmacists, patients, and their families, it complements clinical judgment as each scenario is unique.[3] This topic presents the main issues of concern, clinical significance, and interprofessional aspects of the AGS Beers Criteria®.

The AGS Beers Criteria® was developed to be utilized in an interprofessional, patient-centered approach to avoid adverse drug events and assess the prescription of PIM. Clinicians, pharmacists, nurses, and other professionals should be involved in the integral care of geriatric patients.[3] Several studies have shown that using real-world data based on direct measurements improves patient outcomes and reduces adverse drug events. Databases such as FAERS, WHO VigiBase, and the SYMPATHY Project provide useful information for implementing safe prescribing strategies.[9][6][10] Physicians play an essential role in prescriptions. Nonetheless, it is often challenging for medical professionals to monitor patients' behaviors and global health. Nurses are better positioned to follow patients and understand changes in health status closely. Pharmacists have a deep understanding of medications.[24] In a study conducted in Malaysia, awareness of the AGS Beers Criteria® was less than 40% among pharmacists, meaning that prescriptions were filled without further assessment. Interdisciplinary education and familiarity with the AGS Beers Criteria® are crucial to utilizing system-based review and reducing PIM prescriptions. Promoting pharmacist review of medications, assuming their familiarity with the AGS Beers Criteria®, is a simple intervention that could reduce mistakes.[25]

The AGS Beers Criteria® was developed to be utilized in an interprofessional, patient-centered approach to avoid adverse drug events and assess the prescription of PIM. Clinicians, pharmacists, nurses, and other professionals should be involved in the integral care of geriatric patients.[3] Several studies have shown that using real-world data based on direct measurements improves patient outcomes and reduces adverse drug events. Databases such as FAERS, WHO VigiBase, and the SYMPATHY Project provide useful information for implementing safe prescribing strategies.[9][6][10] Physicians play an essential role in prescriptions. Nonetheless, it is often challenging for medical professionals to monitor patients' behaviors and global health. Nurses are better positioned to follow patients and understand changes in health status closely. Pharmacists have a deep understanding of medications.[24] In a study conducted in Malaysia, awareness of the AGS Beers Criteria® was less than 40% among pharmacists, meaning that prescriptions were filled without further assessment. Interdisciplinary education and familiarity with the AGS Beers Criteria® are crucial to utilizing system-based review and reducing PIM prescriptions. Promoting pharmacist review of medications, assuming their familiarity with the AGS Beers Criteria®, is a simple intervention that could reduce mistakes.[25] The Finnish Interprofessional Medication Assessment was a randomized controlled trial that compared adverse drug events when assessing medications with an interprofessional team versus a conventional approach. The intervention resulted in a statistically significant decrease in adverse events.[26] Another study showed that when utilizing multiple tools to assess medications and a pharmacist-led deprescribing approach, the identification of PIM increased considerably.[22] When collaboration is encouraged, medication management is simplified, and risks are minimized.[24] Physicians should be in constant, reciprocal communication with patients and other professionals. Adequate care transfer helps address barriers and limitations that could harm patients.[6] Appropriately prescribing medications is a key intervention to improve patient outcomes. Medical knowledge is not sufficient to guarantee the elimination of harmful medications. Interprofessional collaboration is essential to achieve the goals of care. Prescriber education, feedback and auditing, and clinical decision support tools should be systematically implemented to improve healthcare practices.[24][21][20]