Inappropriate prescribing: Beers criteria, polypharmacy, and drug burden

As adults age, physiological changes associated with aging, along with an increased prevalence in comorbid conditions and polypharmacy, make prescribing for them a particularly daunting task. Oftentimes, prescribing for older adults means using an adjusted dose (usually lower than generally recommended) and a slower pace in adjusting medications. Because of the changing prescribing paradigm in geriatrics, an effort was made to establish a criteria for selecting medications for senior citizens. To this end, Dr. Mark Beers initiated an effort to identify medications that should generally be avoided in older adults. A revision to the criteria took place, and a summation of that revision was published in 2003. This revision identified potentially inappropriate drugs for seniors, in general, but also brought attention to disease processes that deserved particular attention when prescribing for older adults. Understanding these criteria and the increased likelihood of adverse events with polypharmacy and the increased drug burden will facilitate improved care and better outcomes in our rapidly increasing senior population.