Jay S. Luxenberg, MD

It seems like every decade or so we have a new iteration of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The last one was in 2003, and now we have a new update with a handy, dandy pocket guide and promise of a mobile app clinical tool in the near future. I think that the impact of the new criteria will be fostered by the fact that more and more of us are using electronic health records. I used the criteria to generate some reports, and found plenty of room for improvement. The latest iteration both eliminates references to archaic drugs and adds reference to many new drugs. The criteria take into account recent studies and black box warnings. For example, for antipsychotics the criteria state, "Avoid use for behavioral problems of dementia unless non-pharmacologic options have failed and patient is threat to self or others." Note that "and" – they are really saying that unless the patient is a threat to self or others, then antipsychotics should be avoided – that is a step beyond previous advice that simply said when non-pharmacologic approaches failed to eliminate the troublesome behaviors. If you haven't had a chance to review these new recommendations, please take this opportunity to download them. I am sure there will be discussion of aspects of the new recommendations at our national meetings and at the upcoming CALTCM 38th Annual Meeting.