A Prospective Study on Geriatric Prescribing Pattern and Medication Adherence in a Tertiary Care Hospital

M, Seema Anjum; Jacob, Chinchu; Benchamin, Akhil; Rodrigues, Prudence A

doi:10.22159/ajpcr.2017.v10i12.20460

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…After removing 165 duplicates, a total of 1835 titles and abstracts were screened to determine if they met the inclusion criteria, as described in the methodology section. Full-text assessment of 119 potentially relevant articles resulted in 27 eligible studies (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;Benjamin et al, 2018;Devarapalli et al, 2017;Kumar et al, 2017;Pradhan et al, 2017;Narvekar et al, 2017;Borah et al, 2017;Rakesh et al, 2017;Anjum et al, 2017;Swathi and Bhavika, 2016;Salwe et al, 2016;Chowta et al, 2016;Kashyap et al, 2015;Danisha et al, 2015;Umar et al, 2015;Undela et al, 2014;Dhikav et al, 2014;Karandikar et al, 2013;Momin et al, 2013;Nagendra et al, 2012;Shah et al, 2011;Mandavi et al, 2011;Zaveri et al, 2010;Harugeri et al, 2010), as shown in Figure 1. The list of articles that are excluded (n 92) due to various reasons is presented in Supplementary Table S2.…”

Section: Study Selectionmentioning

confidence: 99%

“…Sample size varied on regional basis from 90 to 1,510, making a total of 11,649 patients. All the studies included both women and men (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;Benjamin et al, 2018;Devarapalli et al, 2017;Kumar et al, 2017;Pradhan et al, 2017;Narvekar et al, 2017;Borah et al, 2017;Rakesh et al, 2017;Anjum et al, 2017;Swathi and Bhavika, 2016;Salwe et al, 2016;Chowta et al, 2016;Kashyap et al, 2015;Danisha et al, 2015;Umar et al, 2015;Undela et al, 2014;Dhikav et al, 2014;Karandikar et al, 2013;Momin et al, 2013;Nagendra et al, 2012;Shah et al, 2011;Mandavi et al, 2011;Zaveri et al, 2010;Harugeri et al, 2010); however, seven studies included more women than men (Dhikav et al, 2014;Umar et al, 2015;Salwe et al, 2016;Kumar et al, 2017;Narvekar et al, 2017;Bhatt et al, 2019;Chandrasekhar et al, 2019). Among the studies, nineteen were cohort design (Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;Benjamin et al, 2018;Devarapalli et al, 2017;…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Among the studies, nineteen were cohort design (Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;Benjamin et al, 2018;Devarapalli et al, 2017;Pradhan et al, 2017;Narvekar et al, 2017;Anjum et al, 2017;Salwe et al, 2016;Chowta et al, 2016;Kashyap et al, 2015;Danisha et al, 2015;Umar et al, 2015;Undela et al, 2014;Dhikav et al, 2014;Karandikar et al, 2013;Nagendra et al, 2012;Shah et al, 2011;Harugeri et al, 2010), and eight were cross-sectional studies (Zaveri et al, 2010;Mandavi et al, 2011;Momin et al, 2013;Swathi and Bhavika, 2016;Borah et al, 2017;Kumar et al, 2017;Rakesh et al, 2017;Bhatt et al, 2019). The majority of the studies were conducted in South India (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Benjamin et al, 2018;Rakesh et al, 2017;Anjum et al, 2017;Swathi and Bhavika, 2016;Salwe et al, 2016;Chowta et al, 2016;Danisha et al, 2015;Umar et al, 2015;Nagendra et al, 2012;Harugeri et al, 2010), six in North India (M...…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The majority of the studies were conducted in South India (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Benjamin et al, 2018;Rakesh et al, 2017;Anjum et al, 2017;Swathi and Bhavika, 2016;Salwe et al, 2016;Chowta et al, 2016;Danisha et al, 2015;Umar et al, 2015;Nagendra et al, 2012;Harugeri et al, 2010), six in North India (Mandavi et al, 2011;Karandikar et al, 2013;Dhikav et al, 2014;Undela et al, 2014;Kashyap et al, 2015;Kumar et al, 2017), three in Eastern states (Devarapalli et al, 2017;Pradhan et al, 2017;Pradhan and Panda, 2018), four in Western region (Zaveri et al, 2010;Shah et al, 2011;Momin et al, 2013;Narvekar et al, 2017) and only one study in North-east India (Borah et al, 2017). Twenty-one studies provided data on the prevalence of polypharmacy (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;Benjamin et al, 2018;Devarapalli et al, 2017;Pradhan et al, 2017;Borah et al, 2017;Rakesh et al, 2017;Anjum et al, 2017;Swathi & Bhavika, 2016;Salwe et al, 2016;…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Twenty-one studies provided data on the prevalence of polypharmacy (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;Benjamin et al, 2018;Devarapalli et al, 2017;Pradhan et al, 2017;Borah et al, 2017;Rakesh et al, 2017;Anjum et al, 2017;Swathi & Bhavika, 2016;Salwe et al, 2016;Chowta et al, 2016;Kashyap et al, 2015;Umar et al, 2015;Undela et al, 2014;Karandikar et al, 2013;Momin et al, 2013;Nagendra et al, 2012;Mandavi et al, 2011;Harugeri et al, 2010), fourteen studies reported estimates of hyperpolypharmacy (Bhatt et al, 2019;Chandrasekhar et al, 2019;Benjamin et al, 2018;Devarapalli et al, 2017;Anjum et al, 2017;Salwe et al, 2016;Chowta et al, 2016;Kashyap et al, 2015;Umar et al, 2015;Undela et al, 2014;Karandikar et al, 2013;Momin et al, 2013;Nagendra et al, 2012;Harugeri et al, 2010), whereas all the twenty-seven studies reported PIM use in the older population (Bhatt et al, 2019;Chandrasekhar et al, 2019;Motallebzadeh et al, 2019;Pradhan and Panda, 2018;B...…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Prevalence of Polypharmacy, Hyperpolypharmacy and Potentially Inappropriate Medication Use in Older Adults in India: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Older people often receive multiple medications for chronic conditions, which often result in polypharmacy (concomitant use of 5‒9 medicines) and hyperpolypharmacy (concomitant use of ≥10 medicines). A limited number of studies have been performed to evaluate the prevalence of polypharmacy, hyperpolypharmacy, and potentially inappropriate medication (PIM) use in older people of developing countries. The present study aimed to investigate regional variations in the prevalence of polypharmacy, hyperpolypharmacy, and PIM use in older people (60 + years) in India.Methods: Studies were identified using Medline/PubMed, Scopus, and Google Scholar databases published from inception (2002) to September 31, 2020. Out of the total 1890 articles, 27 were included in the study.Results: Overall, the pooled prevalence of polypharmacy was 49% (95% confidence interval: 42–56; p < 0.01), hyperpolypharmacy was 31% (21–40; p < 0.01), and PIM use was 28% (24–32; p < 0.01) among older Indian adults. Polypharmacy was more prevalent in North-east India (65%, 50–79), whereas hyperpolypharmacy was prevalent in south India (33%, 17–48). Region-wize estimates for the pooled prevalence of PIM use in India were as follows: 23% (21–25) in East, 33% in West (24–42), 17.8% in North (11–23), and 32% (26–38) in South India. The prevalence of PIM use in adults aged ≥70°years was 35% (28–42), in those taking more medications (≥5.5/day) was 27% (22–31), and in adults using a high number of PIMs (≥3) was 29% (22–36). Subgroup analysis showed that cross-sectional studies had a higher pooled prevalence of polypharmacy 55% (44–65) than cohorts 45% (37–54). Hyperpolypharmacy in inpatient care settings was 37% (26–47), whereas PIM use was higher in private hospitals 31% (24–38) than government hospitals 25% (19–31).Conclusion: Polypharmacy and hyperpolypharmacy are widely prevalent in India. About 28% of older Indian adults are affected by PIM use. Thus, appropriate steps are needed to promote rational geriatric prescribing in India.Systematic Review Registration: https://clinicaltrials.gov, identifier [CRD42019141037].

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Section: Study Selectionmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of Polypharmacy, Hyperpolypharmacy and Potentially Inappropriate Medication Use in Older Adults in India: A Systematic Review and Meta-Analysis

et al. 2021

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Prescription Adherence to Ags Beers Criteria and Medication Adherence in Geriatric Patients

AHMED

MAHESH

DHAKNE

et al. 2022

Asian J Pharm Clin Res

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Objective: The objective of the present study was to determine the prescription pattern and adherence to Beers Criteria 2019 and also evaluate the reasons for non-adherence and ways to promote adherence among geriatric patients. Methods: Retrospective as well as prospective data were collected using a predesigned form. A total of 268 patients aged 60 years and above were involved in the study. The prescriptions were analyzed for appropriateness using AGS Beers Criteria 2019 and the 8-Item Morisky Medication Adherence Scale was used for the assessment of medication adherence. Results: The majority of the patients were in the age group of 65–69 years with a mean age of 73.6 ± 5.05 years with a male preponderance (67%). Out of 268 sample sizes observed, the maximum number of prescriptions had at least one potential inappropriate medication (PIM) – during admission (40.67%) and discharge (48.50%). The most common PIMs observed were PPIs and insulin sliding scale. The use of NSAIDs (aspirin) in heart and renal failure patients was the generally recognized drug-disease and drug-drug interactions. This study confirms the presence of moderate adherence to the prescription among geriatric patients. Conclusion: Even though Beers Criteria have been commonly used as a reference in many studies, it has not made its way into conventional clinical practice. The prescribers need to make themselves aware of the Beers Criteria and it should be followed for the geriatric population. Hence, this study will help physicians to deliver quality care to elderly patients.

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Implications of Mobile Phase Composition and Ph on the Chromatographic Separation of Amitriptyline and Its Metabolite Nortriptyline

Buhagiar

Scorpiniti

Bartolo

et al. 2018

Int J Pharm Pharm Sci

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Objective: Separation of tricyclic compounds sets the keystone for determining parent drug to metabolite concentration ratios and analysing impurities. The combined effects of acetonitrile composition and pH of the mobile phase on the separation of amitriptyline and nortriptyline by reversed-phase high-performance liquid chromatography (RP-HPLC) are presented.Methods: A series of RP-HPLC triplicate runs were carried out using acetonitrile and a phosphate buffer as the mobile phase and a Kinetex® C18 LC Column as the stationary phase using an Agilent 1260 Infinity Series® II liquid chromatography system with UV/visible detection. The stationary phase, column temperature, injection volume and flow rate were kept unchanged during analysis. Mobile phase composition and pH were varied to observe impact on peak shape, resolution and retention time, taking into consideration green analytical chemistry aspects.Results: Optimal chromatographic outcomes were achieved when using the mobile phase made up of 35% acetonitrile and 65% buffer at a pH of 5.6. These conditions resulted in nortriptyline and amitriptyline eluting at 4.66 min and 5.92 min respectively. Increasing the organic modifier content of the mobile phase to 40% completed separation within a run time of 4 min with comparable resolution. The 2 min gained by increasing 5% acetonitrile may not be justified due to potential implications on greening laboratory practices.Conclusion: Reversed-phase chromatography embodies a simple method for the separation of compounds that are similar in structure. Attuning the percentage of organic modifier and buffer pH provides acceptable retention times, without compromising resolution between neighbouring peaks.

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A Prospective Study on Geriatric Prescribing Pattern and Medication Adherence in a Tertiary Care Hospital

Cited by 4 publications

References 2 publications

Prevalence of Polypharmacy, Hyperpolypharmacy and Potentially Inappropriate Medication Use in Older Adults in India: A Systematic Review and Meta-Analysis

Prevalence of Polypharmacy, Hyperpolypharmacy and Potentially Inappropriate Medication Use in Older Adults in India: A Systematic Review and Meta-Analysis

Prescription Adherence to Ags Beers Criteria and Medication Adherence in Geriatric Patients

Implications of Mobile Phase Composition and Ph on the Chromatographic Separation of Amitriptyline and Its Metabolite Nortriptyline

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