Characterization of potentially inappropriate medications use in Indian elderly population and their impact on quality of life using Beers criteria

Abstract

Background Polypharmacy is principal cause of potentially inappropriate medications (PIMs) in elderly patients, which include over prescribing, under prescribing, and misprescribing. Methods Elderly subjects (≥60 years), of either sex, receiving two or more medications for one or more chronic ailments, attending Geriatrics Outpatient Department (OPD), at All India Institute of Medical Sciences (AIIMS) New Delhi, were included. Their prescriptions were assessed for PIMs by using Beers criteria 2015 and were further followed up at least once in 6 months for adverse events, telephonically. The results were analyzed by using suitable regression models and correlation analysis. Results Three hundred eighty patients average age of 65.4 ± 4.7 years were enrolled. Eighty‐eight percent of the people were having greater than or equal to two ailments. Each patient was prescribed 6.7 ± 2.1 medications with 65% of prescriptions having one or more PIMs. Out of the total prescribed drugs, 15% were satisfying Beers criteria for PIMs. There were 63 adverse drug reactions (ADRs) reported. A statistically significant correlation was observed among comorbidities, number of prescribed medications, PIMs, and ADRs. Quality of life (QOL) of the elderly patients was negatively corelated with polypharmacy and female sex. Conclusion A risk‐benefit analysis of prescribed medications is part and parcel of prescribing, especially in elderly patients. In order to decrease further risks associated with inappropriate prescribing, there is need for indigenous guidelines and intensive training.

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

“…Following exclusion of 213 duplicate studies, 1258 studies were excluded by the titles and abstracts. Ninety-four studies with 371 224 692 older outpatients were included for analysis (Figure 1; eAppendix 2 in Supplement 1).…”

“…Forty-one studies were conducted in Asia, followed by 22 studies in Europe, 14 studies in North America, 8 studies in South America, 7 studies in Africa, and 2 studies in Oceania. Between 1999 and 2021, a total of 51 studies were performed in high-income countries, 23 studies in upper- to middle-income countries, 17 studies in lower- to middle-income countries, and 3 studies in low-income countries. Sixty-three studies of the PIM prevalence estimates were based on the Beers criteria, 26 studies…”

“…Between 1999 and 2021, a total of 51 studies were performed in high-income countries, 23 studies in upper- to middle-income countries, 17 studies in lower- to middle-income countries, and 3 studies in low-income countries. Sixty-three studies of the PIM prevalence estimates were based on the Beers criteria, 26 studies were based on the STOPP/START criteria, 13 studies on localization criteria that were developed based on the characteristics of medication for older patients in their own country, and 13 studies on other criteria. Eighty-five studies…”

“…Sixty-three studies of the PIM prevalence estimates were based on the Beers criteria, 26 studies were based on the STOPP/START criteria, 13 studies on localization criteria that were developed based on the characteristics of medication for older patients in their own country, and 13 studies on other criteria. Eighty-five studies were cross-sectional in design, and 11 studies were conducted in a national population survey. The mean age of the participants in most studies (65 studies…”

Potentially inappropriate medication in long-term care wards of a veteran hospital in Taiwan: Investigation using a spreadsheet-based rapid assessment tool

“…The study included 380 patients with an average age of 65.4 years, and 65% of the prescriptions included one or more PIMs. 21 Pattani et al 22 reported similar results; 200 hospitalized older adults had a PIM use prevalence of 53%.…”