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Beers Criteria Updated
The 2012 AGS Updated Beers Criteria was published recently in the Journal of the American Geriatrics Society. Given the importance of the Beers Criteria to insuring high quality care for older adults, the AGS is making the criteria and related professional and public education materials free at www.americangeriatrics.org.
In the coming months, the AGS will be adding a new Smartphone Application and Teaching Slide Presentation to their portfolio of materials based on the 2012 AGS Beers Criteria.
Some important things to note about the updated criteria:
- The Beers Criteria for Potentially Inappropriate Medication (PIM) Use in Older Adults is one of the most frequently consulted sources of information about the safe prescribing of medications for older adults and is used widely in geriatrics clinical care, training, and research. The 2012 American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults has been completely revised and expanded since the 2003 edition, to ensure that clinicians have the best and most up-to-date information about medications that could be harmful to older adults to inform their decisions.
- The new Criteria include three categories of recommendations: (1) medications to avoid in older adults regardless of diseases or conditions; (2) medications considered potentially inappropriate when used in older adults with certain diseases or syndromes; and (3) medications that should be used with caution.
- Fifty-three medications and classes of medications are among those listed as potentially problematic. New medications listed in the category 1 section include “sliding scale” insulin, which research suggests may pose more risks than benefits and for which other alternatives are available. Selective serotonin reuptake inhibitors, which may increase the risks of falling in some older adults, are among the new entries listed in category 2. Vasodilators, which may increase episodes of syncope in older adults with a history of this condition that could increase the risks of falling, are among the new category 3 listings.
- The 2012 AGS Beers Expert Panel (a multidisciplinary panel comprised of eleven experts from medicine, nursing, and pharmacy) followed a process that included a rigorous systematic literature review, building panel consensus through a modified Delphi process, invited peer review combined with an open public comment period, internal peer review by AGS leaders, and grading of the strength of evidence and recommendations.
- The criteria are not meant to be absolute, to substitute for professional judgment, to dictate prescribing habits for an individual patient, or to be punitive in any manner. The criteria are not applicable in all circumstances. The criteria are meant to inform clinical decision-making around personalized treatment plans for individual patients. For example, they do not address the needs of patients receiving palliative care where a prescribing clinician might determine that a medication listed as potentially inappropriate for older adults is the only reasonable choice for that patient.
- The AGS 2012 Beers Criteria is not meant to supersede clinical judgment or an individual patient’s values and needs. Prescribing and managing disease conditions should be individualized and involve shared decision-making. The criteria should be viewed as a guide for identifying medications for which the risks of their use in older adults outweigh their benefits and as a tool to inform clinical decision-making.
Kudos
Medical Student Erika Wood Awarded Scholarship
Erika Wood, a UTHealth second year medical student interested in pursuing geriatric or palliative medicine as a specialty following graduation, was recently awarded a scholarship through the Crawford and Hattie Jackson Foundation. While studying in the MPH program at UNT Health Science Center in Fort Worth, Erika volunteered at a geriatrics clinic and learned about the unique health challenges and rewards of working with elderly patients. She has participated in the Geriatrics and Palliative Medicine scholarly concentration as part of her undergraduate medical education and assisted in coordinating several geriatric medicine workshops and courses. Erika is the current President of the American Medical Student Association and Local Initiatives Director for Students Improving Global Health in Texas. As part of the scholarly concentration program, she will be leading a project on the knowledge and attitudes of medical students regarding palliative care. Her future plans include a residency in Internal Medicine and a fellowship in geriatric or palliative medicine. Congratulations, Erika.
Consortium on Aging Member Receives Hartford Faculty Scholar Grant
Dennis Kao, MSW, PhD, Assistant Professor in the Graduate College of Social Work at the University of Houston and member of the UTHealth Consortium on Aging, was recently awarded a Hartford Faculty Scholars grant for a project using Geographic Information Systems (GIS) to look at health access among aging minorities in Houston.
Recent events
RsVP Lectures Bring Noted Geriatrics Experts
The RsVP (Reynolds Visiting Professor) lecture series, made possible by funding from the D. W. Reynolds Foundation and the Phyllis Gough Huffington Lecture Series II, brought the following renowned geriatrics experts to our campus in 2012:
November 2012
Susan Mitchell, MD, MPH
Professor of Medicine at Harvard Medical School and Senior Scientist at Hebrew SeniorLife in Boston
Dr. Mitchell's presentations were The Role of the Hospital in the Care of Patients with Advanced Dementia and Advanced Dementia.
October 2012
Rosanne Leipzig, MD
Gerald and Mary Ellen Ritter Professor and the Vice Chair for Education of the Department of Geriatrics and Palliative Medicine at Mount Sinai School of Medicine.
Dr. Leipzig's presentations were entitled: Don't Kill Granny and Geriatric Competencies for Medical Students and Internal Medicine Residents.
September 2012
Samuel Durso, MD
Mason F. Lord Professor of Medicine and Director of the Division of Geriatric Medicine and Gerontology
Johns Hopkins University
Dr. Durso's presentation was entitled: Fool's Errand or Fool Proof? Implementing the Checklist Manifesto in the Care of Chronically Ill Older Adults
May 2012
Janice Knebl, DO, MBA
Endowed Chair in Clinical Geriatrics and Professor of Medicine
University of North Texas Health Science Center, Fort Worth
Dr. Knebl presented two programs: (SAGE) Seniors Assisting in Geriatrics Education: Utilizing a Successful Senior Mentoring Program to Train Medical Students in Geriatrics and To Artificially Feed or Not to Feed...Ethical Dilemmas in Dementia
March 2012
Barbara Resnick, PhD, CRNP, FAAN, FAANP
Professor of Nursing at the University of Maryland
President of the American Geriatrics Society
Dr. Resnick presented two programs: Successful Aging: Helping Your Patients Achieve It and Physical Activity: Motivating Older Adults across all Levels of Care.
