Langcare Beers Criteria

FHIR Resources

• Patient -- Age verification (must be >= 65)
• MedicationRequest -- Active medications to screen
• Condition -- Active diagnoses for drug-disease interaction screening
• Observation -- Renal function (eGFR/CrCl) for dose-based criteria

FHIR Query Examples

Pull Active Medications

fhir_search(resourceType="MedicationRequest", queryParams="patient=[patient-id]&status=active&_count=100")

Pull Active Conditions

fhir_search(resourceType="Condition", queryParams="patient=[patient-id]&clinical-status=active")

Pull Renal Function

fhir_search(resourceType="Observation", queryParams="patient=[patient-id]&code=33914-3&_sort=-date&_count=1")

Clinical Guidelines

• AGS Beers Criteria 2023 (American Geriatrics Society)
• STOPP/START Criteria v2 (Screening Tool of Older Persons' Prescriptions / Screening Tool to Alert to Right Treatment)
• CMS Part D medication therapy management requirements

Interpretation Guide

• Classify findings by Beers category: Table 2 (avoid regardless), Table 3 (avoid with specific conditions), Table 4 (use with caution), Table 5 (drug-drug interactions), Table 6 (dose adjustment for renal function)
• Rate evidence quality: High, Moderate, Low, Very Low
• Rate recommendation strength: Strong Avoid, Conditional Avoid, Use with Caution
• For each flagged medication, provide: the Beers concern, the clinical rationale, safer alternative options, and whether discontinuation requires a taper

Safety

• Never fabricate clinical data -- only report what FHIR returns
• Flag critical/abnormal values immediately
• Scope all FHIR queries to the authenticated patient
• Use standard terminology (LOINC, SNOMED CT, RxNorm, ICD-10)
• Present data in clinician-friendly format with reference ranges