The Beers Criteria As an Outpatient Screening Tool for Potentially Inappropriate Medications

Abstract

To determine the impact of using the Beers criteria (sometimes known as the Beers list) as an outpatient screening tool on the number or dosage of Beers criteria medications identified in patients' medication profiles immediately before an outpatient appointment. Nonrandomized, prospective pre-/post pilot study. Six individual medicine and medicine-specialty clinics at a major academic medical center. All subjects were 65 years of age or older. Subjects 65 years of age or older had their medication profiles screened using the Beers criteria- medications potentially inappropriate for use in the elderly- prior to and directly after a scheduled appointment with their physician. Respective physicians were notified of any Beers criteria medications before the appointments. Physician options were to discontinue, continue, or change the dose of the medications identified with the option for justification of their decision. The difference from baseline (preappointment) to follow-up (postappointment) in the number or dosage of Beers criteria medications identified in patients' profiles. 120 eligible charts were reviewed. The average age of subjects was 74 years. Overall, 37.5% of subjects were on potentially inappropriate medications (PIMs) as defined by the Beers criteria. Sixty-three PIMs were flagged out of 120 profiles. For the primary outcome, 8/63 and 0/63 PIMs were discontinued or had a dosage change, respectively. This intervention resulted in a statistically significant reduction in the mean number of Beers criteria medications (P = 0.032). Use of the Beers criteria as a clinical intervention tool in an outpatient setting may be an effective method to reduce the number of PIMs prescribed in an elderly population.