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Beers Criteria (PIMs)
2023 AGS Beers Criteria — Check any medications present on the patient's current medication list.
Select all that apply to current medication list
Central Nervous System
Anticholinergics
Cardiovascular
Pain & Anti-inflammatory
Endocrine & Diabetes
GI Drugs
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Medication reconciliation review in all patients ≥ 65 at admission, discharge, and routine clinic review.
Polypharmacy assessment — particularly when > 5 medications are prescribed.
Pre-operative medication review to reduce perioperative drug-related adverse events.
Pharmacy-led deprescribing rounds in long-term care and nursing home settings.
Scope of the Beers Criteria
The 2023 AGS Beers Criteria covers 5 categories: (1) PIMs in all older adults, (2) PIMs in specific diseases/conditions, (3) drugs to use with caution, (4) drug-drug interactions, (5) drugs to avoid or adjust for renal impairment.
Beers Criteria is primarily US-focused and does not include prescribing omissions (drugs that SHOULD be started). STOPP/START (European) identifies both potentially inappropriate drugs (STOPP) and evidence-based drugs that are being omitted (START). Both tools have complementary value and should ideally be used together.
Not an Absolute Contraindication List
Beers Criteria items are "potentially" inappropriate — not unconditionally contraindicated. Clinical context, patient goals, and expected benefit always supersede list-based rules. Document the rationale when prescribing a Beers-listed drug after risk-benefit assessment.
Section 4
Next Steps
Deprescribing Approach
Section 5
Evidence Appraisal
Primary Reference
2023 American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
American Geriatrics Society 2023 Beers Criteria Update Expert Panel. • J Am Geriatr Soc.. 2023;71(7):2052–2081. Systematic review-based update; covers 5 categories of medication concerns in older adults.
Section 6
Origins
Mark Beers — Northwestern University
Originally developed by Mark Beers at Northwestern University in 1991, initially focused on nursing home residents. The criteria were subsequently expanded to all community-dwelling older adults and adopted by the American Geriatrics Society (AGS) for iterative updates (1997, 2003, 2012, 2015, 2019, 2023). The 2023 update is the most comprehensive, incorporating systematic literature reviews and formal expert consensus using modified Delphi methodology.
