Physicians Urged to Review,
Consult Beers List

Mark H. Beers, M.D., might not be at the top of your mind when you pull out your prescribing pad for a patient over age 65 — but maybe he should be.

Beers was the senior researcher who pulled together a group of 12 geographically diverse medical experts in 1991 to compile a list of drugs with potential adverse indications for senior patients. The group has updated its criteria — known as the Beers List — twice since then, most recently in 2003.

While the Beers List is not evidence-based, it does represent thoughtful consensus about which medications may pose risks to older patients. Under a physician’s clinical judgment, some of the listed medications might be worthwhile, based on relative contraindications, while others should be avoided.

Why use the list?
“In seniors, the drugs on the Beers List generally interfere with motor skills and mental capabilities — which can enhance the likelihood of a senior falling, stumbling, not walking properly or having some activities of daily living become more difficult,” cautioned Robert Pope, M.D., chief medical officer, Humana senior products. “On the mental side, they may slow down recognition or the ability to concentrate and focus. All of these effects increase the risk of other, serious injuries for seniors.”

Yet many older Americans take these drugs. In 2006, a Humana study of claims found that medications on the Beers List accounted for $77 million in prescriptions for Humana members over 65 years old.

“For some medications on the list, such as skeletal muscle relaxants, there’s a real safety issue,” Pope said. “People released from the hospital may, as an effect of the medication, lose their balance, fall and break a hip.”

Pope noted that the lifestyle and economic impacts resulting from drugs prescribed without due consideration could be staggering when falls and their after-effects are taken into account.

What is Humana doing?
Humana encourages physicians to refamiliarize themselves with the Beers List and review it when prescribing for seniors. In addition, Humana is taking the following steps:

• Humana’s pharmacy claims processor is now sending warning messages to pharmacists regarding certain drugs on the list.
• Humana’s mental health provider, Corphealth, is sending letters to physicians alerting them to potential drug issues.
• Humana’s member safety committee is looking into a “falls prevention” program that would examine the location, cause and effects of falls in seniors in an effort to reduce their occurrence.

“All doctors have been trained on the Beers List, and we know the potential side effects of these medications,” Pope said. “Probably, however, most of us haven’t reviewed the list in quite some time. It’s a good time for doctors to look at the list, be reminded what it contains and use sound clinical judgment when prescribing to seniors.”

Back to top