Background: Elderly people have multiple co morbidities and are often prescribed potentially inappropriate medications (PIMs). As there is paucity of information about the prescribing practices in elderly this study was undertaken to assess drug utilization patterns in elderly patients.Methods: A prospective observational study was conducted in a tertiary care hospital. A total of 576 prescriptions of elderly patients were included in the study. Prescribing patterns among elderly patients attending OPD and admitted to wards of departments of Medicine, Psychiatry, Dermatology, Pulmonary Medicine, General Surgery, E.N.T., Ophthalmology, Orthopaedics, Obstetrics and Gynaecology were analysed using the prescribing indicators (WHO criteria). The PIMs were identified as per the Beers 2012 criteria.Results: The average number of drugs per patient was 3.91±1.93 for O.P.D and 7.37 ±2.22 for I.P.D. patients. 37.76% patients in I.P.D. and 26.87% patients in O.P.D. received a medication which was potentially inappropriate as per Beers 2012 criteria. 7.58% (234/3088) of total medications prescribed to patients in the study were potentially inappropriate. There was a significant increase in the number of PIMs (p value ˂0.05) as the total number of drugs prescribed increased.Conclusions: Educational programmes are needed to reinforce rational prescribing by physicians and precautions should be taken while prescribing potentially inappropriate drugs to elderly patients.

Objectives:Appropriate treatment of hypothyroidism requires accurate diagnosis. This registry aimed to study the disease profile and treatment paradigm in hypothyroid patients in India.Materials and Methods:We registered 1500 newly diagnosed, treatment-naïve, adult hypothyroid males and nonpregnant females across 33 centers and collected relevant data from medical records. The first analysis report on baseline data is presented here.Results:The mean age of the study population was 41.1 ± 14.01 years with a female to male ratio of 7:3. The most frequently reported symptoms and signs were fatigue (60.17%) and weight gain with poor appetite (36.22%). Menstrual abnormalities were reported in all women (n = 730) who had not attained menopause. Grades 1 and 2 goiter (as per the WHO) were observed in 15.41% and 3.27% patients, respectively. Comorbidities were reported in 545 patients (36.36%), type 2 diabetes mellitus being the most prevalent (13.54%) followed by hypertension (11.34%). Total serum thyroxine (T4) and thyroid-stimulating hormone (TSH) levels were assessed in 291 (19.47%) patients only. In majority of patients (81%), treatment was based on serum TSH levels alone. The dose of levothyroxine ranged from 12.5 to 375 mcg.Conclusions:Guidelines suggest a diagnosis of hypothyroidism based on TSH and T4 levels. However, most of the patients as observed in this registry received treatment with levothyroxine based on TSH levels alone, thus highlighting the need for awareness and scientific education among clinicians in India. The use of standard doses (100, 75, and 25 mcg) of levothyroxine may point toward empirical management practices.