Document Type

Article

Publication Date

8-1-2024

Abstract

Since the original Beers Criteria were developed in 1991 and subsequently expanded in 1997, the American Geriatric Society (AGS) Beers Criteria has become a very useful source of information to optimize patient safety and minimize patient harm in older adults (age older than 65 years).1 Recently, the AGS published its 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults.2 This 2023 publication reviewed evidence published between 2017 and 2022 in order to update the previously published AGS 2019 Beers Criteria. The review we present below is focused solely on the recommendations within the 2019 and 2023 AGS publications pertaining to anticoagulation with the direct acting oral anticoagulants (DOACs). We are concerned with the changes in the AGS recommendations for rivaroxaban, relative to apixaban, outlined in the 2023 publication.2 As stated in the 2023 publication, “The recommendation for rivaroxaban has changed from ‘use with caution,’ to ‘avoid’ for long-term treatment of nonvalvular atrial fibrillation (NVAF) and venous thromboembolism (VTE), with the rationale being that observational studies and network meta-analyses find that this drug confers a higher risk of major and gastrointestinal (GI) bleeding in older adults than other DOACs, particularly apixaban but also dabigatran.”2 The basis of this text is concerning to us as health care providers for older adults (age older than 65 years), who require oral anticoagulation.

Comments

10.1016/j.mayocpiqo.2024.05.004

Publisher Attribution

© 2024 THE AUTHORS. Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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