PRESCRIPTION ANALYSIS AND PREVALENCE OF POTENTIALLY INAPPROPRIATE MEDICATION USE IN OLDER ADULTS; AN OBSERVATIONAL STUDY

Authors

  • N. SENTHIL KUMAR JKKMMRF’S Annai JKK Sampoorani Ammal College of Pharmacy, Ethirmedu, B. Komarapalayam 638183, Namakkal Dt, TamilNadu, The Tamilnadu DR. M. G. R. Medical University, Chennai
  • GEENA K. REJI JKKMMRF’S Annai JKK Sampoorani Ammal College of Pharmacy, Ethirmedu, B. Komarapalayam 638183, Namakkal Dt, TamilNadu, The Tamilnadu DR. M. G. R. Medical University, Chennai
  • REEMA K. A. JKKMMRF’S Annai JKK Sampoorani Ammal College of Pharmacy, Ethirmedu, B. Komarapalayam 638183, Namakkal Dt, TamilNadu, The Tamilnadu DR. M. G. R. Medical University, Chennai
  • VIJAYARANGAN S. JKKMMRF’S Annai JKK Sampoorani Ammal College of Pharmacy, Ethirmedu, B. Komarapalayam 638183, Namakkal Dt, TamilNadu, The Tamilnadu DR. M. G. R. Medical University, Chennai
  • RAMYA A. JKKMMRF’S Annai JKK Sampoorani Ammal College of Pharmacy, Ethirmedu, B. Komarapalayam 638183, Namakkal Dt, TamilNadu, The Tamilnadu DR. M. G. R. Medical University, Chennai

DOI:

https://doi.org/10.22159/ijpps.2020v12i2.36209

Keywords:

Elderly patients, Older adults, Potentially inappropriate medications, Adverse Drug reactions, Nil

Abstract

Objective: The objectives of the present study were to determine the prevalence of Potentially Inappropriate Medications and Adverse Drug Reactions in older adults and to collect doctors’ responses regarding the PIM list or any other criteria to treat older adults in India.

Methods: This was an observational study conducted in different tertiary care hospitals of two districts, Erode and Salem after obtaining approval of the Institutional Ethics Committee. A sample of 250 older adults (60 y and above) and 97 doctors were included during the study period of 6 mo from February 2019 to July 2019. Inappropriate medications were identified by using 2019 updated Beer’s criteria. The causality of the adverse events was assessed by Naranjo Adverse Drug Reaction Probability Scale.

Results: Out of the 250 prescriptions, only 86(34.4%) of the prescriptions were appropriate and 164(65.6%) were inappropriate. The most commonly inappropriate prescribed medications were diuretics, ranitidine, and tramadol. A total of 74 ADRs was observed in 74 patients. Of these, 57(22.8%) ADRs were due to inappropriate medications listed in Beers criteria. There was a significant association between the occurrence of ADRs and the use of PIMs listed in 2019 updated Beer’s criteria [χ2 = 6.08, P = 0.013 (df = 1)].

Conclusion: The study shows that there is a high prevalence of inappropriate medications and adverse drug reactions in hospitalized older adults. Beer’s criteria can be used as a guideline by the physicians while prescribing the drugs to the geriatric population.

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References

King M, Lipsky MS. Clinical implications of aging. Disease Month 2015;61:467-74.

Government of India, Ministry of Statistics and programme implementation. Elderly in India-Profiles and Programmes. New Delhi: Central statistics Office; 2016. p. 1-18.

Kashyap M, Iqbal MZ. A review of screening tools used for the assessment of the appropriateness of prescription`s among elderly patients. J Pharm Biosci 2014;3:72-9.

Aronson JK. Rational prescribing, appropriate prescribing. Br J Clin Pharmacol 2004;57:229-30.

Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med 1991;15:1825-32.

By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 updated ags beers criteria® for potentially inappropriate medication use in older adults. J Am Geriatric Soc 2019:67:674-94.

Anderson GF, Hussey PS. Population aging: a comparison among industrialized countries. Health Aff (Millwood) 2000;19:191-203.

Ramaswamy R, Maio V, Diamond JJ, Talati AR, Hartmann CW, Arenson C, et al. potentially inappropriate prescribing in elderly: Assessing doctor knowledge, confidence and barriers. J Eval Clin Pract 2011;17:1153-9.

Senthilvel N, Sowmya R, Sreerekha S, Srisha R. A study on prescribing pattern of drugs in geriatrics using Beer’s criteria at a private corporate hospital. Int J Pharm Sci Res 2015;6:4810-25.

Rohit SR. Evaluation of potentially inappropriate medication use and risk of adverse drug reactions in hospitalized older adults: an observational study in a tertiary care hospital. Indian J Pharm Practice 2018;11:79-85.

Harugeri A, Joseph J, Parthasarathi G, Ramesh M, Guido S. Potentially inappropriate medication use in elderly patients: a study of prevalence and predictors in two teaching hospitals. J Postgrad Med 2010;56:186-91.

Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi C. Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India. Perspect Clin Res 2014;5:184-9.

Shah KN, Joshi HM, Christian RP, Patel KP, Malhotra SD. Prevalence of potentially inappropriate medications and prescription cost analysis among older cardiac patients in an outpatient department of a tertiary care hospital in India. J Basic Clin Pharm 2016;7:110-5.

Vishwas HN, Harugeri A, Parthasarathi G, Ramesh M. Potentially inappropriate medication use in Indian elderly: comparison of beer’s criteria and screening tool for older persons potentially inappropriate prescriptions. Geriatric Gerontol Int 2012;12:506-14.

Jayanthi CR, Renuka M, Panchaksharimath P. An observational study to analyse the adverse drug reactions among the elderly at a teritary care hospital. Biomed Pharmacol J 2017;10:345-52.

Borah L, Devi D, DEbnath PK, Deka D. A study of drug utilization pattern of the geriatric patients in the department of geriatric medicine in a tertiary care hospital in Assam, India. Asian J Pharm Clin Res 2017;10:122-6.

Anju SM, Jacob C, Benchamin A, Rodrigues PA. A prospective study on geriatric prescribing pattern and medication adherence in a tertiary care hospital. Asian J Pharm Clin Res 2017;10:220-5.

Published

01-02-2020

How to Cite

KUMAR, N. S., G. K. REJI, R. K. A., V. S., and R. A. “PRESCRIPTION ANALYSIS AND PREVALENCE OF POTENTIALLY INAPPROPRIATE MEDICATION USE IN OLDER ADULTS; AN OBSERVATIONAL STUDY”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 12, no. 2, Feb. 2020, pp. 108-12, doi:10.22159/ijpps.2020v12i2.36209.

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Original Article(s)