Potentially inappropriate medications, drug-drug interactions, and prescribing practices in elderly patients: a cross-sectional study

SUMMARY OBJECTIVE: To evaluate potentially inappropriate medications, potential drug-drug interactions, and prescribing practices in elderly ambulatory patients. METHODS: We carried out a cross-sectional study on 275 elderly patients attending different outpatient departments. We used the Screening Tool for Older Person's Prescriptions criteria version two to identify potentially inappropriate medications, IBM Micromedex, to categorize potential drug-drug interactions as major and moderate. World Health Organization prescribing indicators were used to evaluate prescribing practices. RESULTS: The prevalence of potentially inappropriate medications in 275 prescriptions was 21.9%. Diclofenac was the most common inappropriate drug (n=23). Metoprolol is the second most inappropriate drug (n=12). Amlodipine and clopidogrel, aspirin and furosemide, and aspirin and spironolactone together accounted for 71.42% of major interactions (n=15). Atorvastatin and clopidogrel was the most common moderate drug-drug interaction in our study (n=24). The average number of drugs per encounter, the percentage of drugs with a generic name, and the percentage of drugs from the essential drugs list must be improved. CONCLUSION: There is a need to provide awareness through education about the explicit criteria to identify potentially inappropriate medications and prescribing indicators that aid in rational prescribing in the elderly.

Drug Utilization Evaluation of Anticancer Drugs in a Tertiary Care Teaching Hospital: a Descriptive Observational Study.

Drug Utilization Evaluation (DUE) promotes rational use of drugs. The aim of present study was to conduct DUE of anticancer drugs. Newly diagnosed and/or known case of carcinoma which required treatment with chemotherapy, patients of both sex, and age >18 years were included in the study. Patients diagnosed as having carcinoma that also required surgical intervention, radiotherapy or other modality of management were excluded from the study. WHO core prescribing indicators are used to know about polypharmacy, excessive use of antibiotics, percentage of drugs prescribed by from Essential Drugs List (EDL). Females were commonly affected than males. Patients of age group 41-50 years (mean 52.43, SD ±7.77) constituted the highest number, 34% and 13% in rural and urban population respectively. 5-Flurouracil and Cisplatin are most commonly prescribed anticancer drugs followed by Cyclophosphamide. The most commonly used adjuvant drugs in our study are Diclofenac, B-Complex, Granisetron, Ranitidine, Dexamethasone, Ondansetron, and Mannitol. The cytoprotectant drugs observed in our study are Leucovorin, Mesna and Peg-Filgrastim. Average number of Cytotoxic Drugs per prescription was 1.97. Average number of drugs per prescription was 8.16. Percentage of drugs prescribed from Essential Drugs List (EDL) was 88.4%. Percentage of encounters with an antibiotic prescribed was 54.8%. Polypharmacy, unnecessary antibiotic and injection prescribing were not observed. The percentage of drugs from EDL may be improved.