Using Beers Criteria to Improve Safety in Alternate Level of Care Patients

The Beers criteria identify potentially inappropriate medications (PIMs), which may cause adverse events in elderly patients. A new study applied the Beers criteria, retrospectively, to 52 alternate level of care (ALC) patients to determine whether PIMs had contributed to adverse events in this population. ALC patients, who have completed a hospital stay and await placement elsewhere, often have complicated medication regimens, the effects of which have not been previously examined in these patients.

A chart review revealed that 48 of 52 patients (92%) were taking a PIM. The patients experienced a total of 922 adverse events, of which 407 were associated with a regularly scheduled PIM. Further, patients who were taking regularly prescribed PIMs had a significantly increased likelihood of an adverse central nervous system event or a fall (p<0.001 for both events). First-generation antihistamines (46%), antipsychotics (40%), short-acting benzodiazepines (29%), and non-benzodiazepine hypnotics (27%) constituted the most common PIM medications in this group. Adverse events, which were common in the ALC patients, may be prevented by medication review using the Beers criteria.


Slaney H, MacAulay S, Irvine-Meek J, Murray J. Application of the Beers criteria to alternate level of care patients in hospital inpatient units. Can J Hosp Pharm. 2015; 68(3):218-225.

Posted in Applied Research