ABSTRACT
Aim: The study aimed to determine the prevalence of potential drug-drug interactions (PDDIs) and potentially inappropriate medications (PIMs) among geriatrics. Methods: A prospective observational study was conducted for six months in the Department of Geriatrics, M.S. Ramaiah Teaching Hospital, Bangalore. PDDIs and PIMS were analyzed using micromedex database and Beer's criteria respectively. Results: Among 395 prescriptions, 221(56%) prescriptions showed 559 pDDIs and 41(10.4%) PIMs. Almost 281(50.3%), 260(46.5%), 16(2.7%) and 2(0.3%) pDDIs were categorised as major, moderate, minor and contraindicated respectively. Almost 321(57.5%) were synergistic and 196(35.0%) were antagonistic drug interactions. Pearson correlation value (R) is 0.9957 which showed a strong positive correlation. Conclusion: This study created awareness on drug interactions among geriatrics and help the practitioners to prescribe drugs with a low risk of pDDIs. The authors suggest PIM monitoring in geriatrics to avoid adverse effects and improve patients' quality of life.
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.
ABSTRACT
Background: Information regarding prescribing potentially inappropriate medications (PIMs) in elderly has not been well documented. Methods: The study was a cross sectional study done by analysing the case records of elderly patients admitted to general medicine and general surgery wards. The data was collected in a proforma which included patient’s name age, sex, diagnosis, investigations, and prescription. Beer’s explicit criteria 2012 were used to identify the PIMs in prescriptions. Multivariate logistic regression analysis was done to know the potential factors associated with prescribing PIMs. Results: The results showed that 44 out of 132 patients received atleast one PIM. The average number of drugs prescribed per patient was 7.5 (range 2-15). Out of 931 drugs prescribed 63 were found to be potentially inappropriate. Polypharmacy was a major factor associated with prescribing PIMs. Conclusions: Prescribing potentially inappropriate medications is common in elderly in-patients, polypharmacy being a major factor associated with prescribing PIMs.