Prevalence of potentially inappropriate medication and its correlates in elderly hospitalized patients: A cross-sectional study based on Beers criteria

Abstract

BACKGROUND: The increase in the prescription of potentially inappropriate medication (PIM) in older adults with significant health consequences is a global concern. This study aimed to determine the prevalence of PIM prescription in older adults as identified by Beers criteria 2015 and 2019. MATERIALS AND METHODS: A cross-sectional study was carried out in older adults aged >65 years at a tertiary care postgraduate teaching hospital. All patients aged ≥65 years irrespective of their gender, admitted in the medical ward of the hospital with single/multiple comorbidities, and prescribed at least one daily medication, were included in the study. Data of patient history, patient case sheet, medication charts, laboratory reports, as well as radiological examinations test reports were retrieved from their files and were captured in a prevalidated data collection form. SPSS used for data analysis; multivariate logistic regression was used to determine the predictors of PIM prescribing and odds ratios (ORs) and 95% confidence intervals for ORs were computed. RESULTS: Study included 323 patients; 61.3% were male, 74% patients were 65–70 years of age, and 78% patients were illiterate. The overall prevalence of PIM uses according to the Beers criteria 2015 and 2019 was 60.1% and 61.9%, respectively. No association found between PIMs prescribes and diagnosis category. Male gender, age 76–80 years, and education 10–12th class were found to be significantly related to PIM prescription. CONCLUSION: This study reflects a critical view of noncompliance of Beers criteria for geriatric healthcare even in tertiary care hospitals in India. Creatinine clearance rate should be kept in view when prescribing medicines for elderly inpatients.

Analysis of Medication Charts of Hospitalized Elderly Patients: A Cross-sectional Study

“…the Beer's criteria 2019. The current study witnessed male predominance (55%) which was found to be similar to other studies 10,11 whereas Zhang H, et al 12 reported predominance of female. The mean age ± SD of the present study population (70.67 ±5.43 years) was found to be less than reported earlier as 75.17 ± 7.66 years 11 and 75.3±7.3 years 12 and higher than reported by Narvekar RS, et al 13 (68.88 years).…”

“…This was found to be consistent with other studies. 10,11 Median length of hospital stay (4.5 days) was found to be less when compared to 6 days in the study conducted by Sharma, et al 10 and 6.44 days by Narvekar R, S et al 13 A higher proportion of the elderly had multiple co-morbidities in the present study and only 15% had a single disease. The average number of diagnoses was found to be 3.61±2.02 This was found to be less than that reported (4.0±2.0) by Zhang H, et al 12 and slightly higher than that reported (3.37) by Narvekar R, S et al 13 69% of the elderly had ≥ 3 diagnoses in the current study which was found to be greater than reported in the study conducted by Sharma, et al 10 (62.5%).…”

“…10,11 Median length of hospital stay (4.5 days) was found to be less when compared to 6 days in the study conducted by Sharma, et al 10 and 6.44 days by Narvekar R, S et al 13 A higher proportion of the elderly had multiple co-morbidities in the present study and only 15% had a single disease. The average number of diagnoses was found to be 3.61±2.02 This was found to be less than that reported (4.0±2.0) by Zhang H, et al 12 and slightly higher than that reported (3.37) by Narvekar R, S et al 13 69% of the elderly had ≥ 3 diagnoses in the current study which was found to be greater than reported in the study conducted by Sharma, et al 10 (62.5%). Hypertension followed by type 2 diabetes mellitus, sepsis, and coronary artery disease were found be to more common ailments found which is found to be different from a previous study conducted by Sharma, et al 10 where diabetes (36.2%) was the most common disease followed by cerebrovascular events, chronic kidney disease, cardiovascular disease, and hypertension.…”

Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study

“…The results of our study are similar to the recent study that applied 2019 Beers Criteria on patients aged 65–74 years attending primary care centers in Spain and which reported a PIM prevalence of 68.8% [ 22 ]. Furthermore, another recent study by Sharma et al reported that nearly 62% of older patients aged 65–70 years received at least one PIM during hospitalization [ 23 ]. To date, there are no data available on T2DM patients using the latest version of Beers Criteria 2019 with which to make any comparison.…”

“…The results show that hypertension (49.3%) was the most common comorbidity in older patients with T2DM. The results are compared with various research studies that showed hypertension to be the primary cause of morbidity in the older population with T2DM [ 23 ].…”