Title:Prevalence and Predictors of Potentially Inappropriate Medication Use
Among Elderly Patients Using Updated Beers Criteria 2019: A Single Centered
Retrospective Analysis
Volume: 17
Issue: 1
Author(s): Syam Sundar Chinthalapudi, Srilakshmi Cheeti , Aditi Bajpai , S. Deepika, Girish Thunga , Muhammed Rashid , Raviraja V. Acharya and Sreedharan Nair *
Affiliation:
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education,
Manipal, Karnataka 576104, India;
Keywords:
Inappropriate prescribing, potentially inappropriate medication, beers criteria, polypharmacy, medication, elderly, drug-related problem.
Abstract:
Background: Inappropriate medication use poses a sizable health safety hazard in the
elderly owing to aging-associated physiological and anatomic changes. Inappropriate drug prescribing
and polypharmacy in this population elevate the risk of adverse drug reactions (ADR). The
study aimed at assessing the prevalence and predictors of Potentially Inappropriate Medication
(PIM) use in elderly patients according to updated Beers Criteria 2019.
Methods: Medical records of 402 patients aged ≥65 years admitted to a tertiary care hospital from
June 2018 to May 2019 were analyzed. The patients who received at least one PIM based on the
2019 Updated Beers Criteria were considered as test cases and others as control. Data were presented
as descriptive statistics, and logistic regression was performed to assess the factors affecting the
outcomes.
Results: The mean age was found to be 73.7 ±6.4 years in the test and 70.5±5.5 years in the control
group. The prevalence of PIMs to be used with caution was found to be 54%. Whereas the prevalence
of PIMs to be avoided and to be used with reduced dose was found to be 45% and 1%, respectively.
The most prescribed PIMs were aspirin, diuretics, long-acting sulfonylureas, and proton
pump inhibitors (PPIs). Increasing age, polypharmacy, and the number of drugs in medication history
were significantly (p<0.05) correlated with a substantial risk of PIM use. The risk of developing
serious and moderate drug-drug interactions (DDIs) was significantly high in the test group
(p<0.05) when compared to the control group.
Conclusion: A high prevalence of PIMs was observed in this study. Age, polypharmacy, and ≥ 3
drugs in medication history were identified as risk factors for PIM use, and at a higher risk of developing
DDIs. Continuous medication reviews by clinical pharmacists can aid in reducing the occurrence
of PIMs amongst geriatrics.
