Impact of updated beer's criteria on percentage of inappropriate medication use in long-term care facility

Document Type


Date of Publication


Publication Title


First Page


Last Page



PURPOSE :The 2012 update to the Beer’s Criteria included the addition of new medications that are potentially harmful to those over the age of 65 years, as well as the removal of drugs no longer on the market or those that have been deemed safe in older adults. The update resulted in a 65% increase in potentially inappropriate medications (PIMs) from the 2003 criteria. This increase has the potential to affect quality measures based on the criteria. The purpose of this study was to compare the 2003 and 2012 Beer’s criteria by evaluating the percentage of PIMs in residents of a long-term care facility (LTCF).

METHODS: A retrospective review of medication administration records (MAR's) was performed to collect medication data from all residents of a LTCF in central NC as of November 30, 2012.The following data was collected: total number of medications, number of PIMs according to the 2003 and 2012 Beer’s criteria and organ system or therapeutic category of 2012 Beer’s PIMs medications. Percentages of PIMs were calculated for 2003 and 2012 and compared using a t-test.

RESULTS: Fifty-four patients met the inclusion criteria and were included in the analysis. Of the medications administered, 2.1%were on the 2003 Beer’s criteria and 4.9% were on the 2012 Beer’s criteria for an increase of 2.8% (p<0.01). Medications from the Beer’s criteria prescribed most often were insulin use via sliding scale, antipsychotics and benzodiazepines.

CONCLUSIONS: The update of the Beer’s criteria in 2012 resulted in a large increase of included drugs. In this long-term care facility, the update resulted in a significant increase of the percentage of PIMs. In-services educating prescribers of the common classes from the new Beer’s criteria will hopefully result in an overall decrease in the use of PIMs in older adults.