• Sule Ajibola Saka, Frasia Oosthuizen, and Manimbulu Nlooto.
• Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
• J Eval Clin Pract. 2020 Oct 1; 26 (5): 1522-1529.

Rationale, Aims And ObjectivesThere are currently no criteria to guide appropriate prescribing to older persons in Africa. Although the American Geriatrics Society-Beers (AGS-Beers) Criteria appear to be favoured by African researchers, there is a need to adapt its recommendations to the continent's health care systems. This study aimed to adapt the AGS-Beers recommendations to Nigerian and South African health care contexts.MethodsA modified Delphi technique was used to explore Nigerian and South African experts' consensus on the applicability of the 2015 AGS-Beers Criteria recommendations to older persons in Africa. Thirty-two recommendations, 21 from the parent Criteria and 11 modified, were explored among 10 purposively selected medical and pharmacy experts in a predetermined two-round survey that utilized a 5-point Likert scale. Consensus was defined as a lower-limit 95% CI mean ratings of ≥3.0.ResultsOverall, the experts reached consensus on 62.5% (20/32) of the recommendations and 76.2% (16/21) of the parent AGS-Beers' recommendations specifically. While the experts consensually agreed that medications with strong anticholinergic effects should be generally avoided in older persons, mean = 4.11 (SD = ±1.27, 95% CI, 3.14-5.09), they could not reach a consensus on the context-specific recommendation to avoid amitriptyline in neuropathic pain mean = 3.11 (SD = ±1.05, 95% CI, 2.30-3.92).ConclusionsThe 2015 AGS-Beers Criteria were adapted to the Nigerian and South African health care contexts. The adapted and the parent recommendations differed in their context specificity. The recommendations may serve as a guide to clinicians when prescribing medications to older persons in Nigeria and South Africa.© 2019 John Wiley & Sons, Ltd.

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