A Prospective Observational Study on Potentially Inappropriate Medications in Geriatrics Using Beer’s Criteria

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Vivekanandan K, Gokula Priya M, Hariharan J, Devasenathipathi A S, N Venkateshan, E Bhavya


Background: The major cause of adverse drug events in geriatrics is inappropriate prescribing of medications and this may lead to morbidity and mortality. The American Geriatrics Society Beers Criteria (AGS Beers Criteria) for potentially inappropriate use of medications in older adults are used widely. The final updated criteria has three categories: a) Potentially inappropriate medications and classes to avoid in older adults, b) Potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes, c) Medications to be used in caution in older adults.

Objective: The objective of the study is to evaluate the use of potentially inappropriate medications in older adults using Beers Criteria.

Materials and Method: A Prospective Observational Study was conducted in the major departments (General Medicine, General Surgery, Orthopedics and Respiratory Medicine) of multispecialty Hospital, Virudhunagar. The study was conducted over a period of 6-8 months.

Results: 107 elderly patients with age above 65 years were included in the study. Out of these 107 patients 87% of the patients were with comorbidities and 13% of the patients were without comorbidities. A total of 1142 drugs were prescribed as an average of 10.6 drugs per patient. Among 107 patients 96 patients (89.7%) were prescribed with inappropriate drugs and 11 patients (10.3%) were prescribed with appropriate drugs. A total of 256 inappropriate drugs (22.4%) were prescribed. Among these 256 inappropriate drugs, 21 patients(19.6%) received one inappropriate medication, 36 patients(33.6%) received two inappropriate medications, 15 patients(14%) received three inappropriate medications, 12 patients(11.2%) received four inappropriate medications, 3 patients(2.8%) received five inappropriate medications, 8 patients(7.5%) received six inappropriate medications and 1 patient(0.9%) received seven inappropriate medications.

Conclusion: The risk of potentially inappropriate medications is increasing day by day due to inappropriate prescribing. The physician should consider the age, pharmacokinetics, pharmacodynamics and comorbidities of the patient while prescribing medications. A multidisciplinary team should be appointed in every hospital to find out the inappropriate prescribing and to evaluate medication adherence. Rational drug use should be practiced. 

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