Studies published in the late 1990s about polypharmacy, inappropriate medication use, and adverse drug events in older people had a salutary effect—or, some might say, a chilling effect—on drug prescribing. Finding out just how differently the “usual” drugs worked in older patients had some clinicians second-guessing their own prescribing habits. Now a consensus panel of experts has further updated one of the most famous studies: the widely used Beers criteria, published in 1997. Forty-four medications have been added to the list of drugs to watch, and 15 medications or drug classes have been dropped or modified.
The criteria are meant to apply to the general population of patients 65 and older. Thus, some drugs that are not appropriate for “old-old” or more frail patients do not appear on the list.
The panel also cautions that “defining inappropriate medications by specific lists of medications rather than other mechanisms may miss some problems such as the underuse and interactions of drugs in older people.”