Evaluation of the appropriateness of prescribing in geriatric patients using Beers criteria and Phadke's criteria and comparison thereof

Abstract

Objectives:To evaluate appropriateness of prescribing medicines in geriatric patients using both Beers criteria and Phadke's criteria and compare them for validation of Phadke's criteria as a tool to evaluate rationality of prescribing in elderly.Materials and Methods:A cross-sectional prospective observational study was conducted and the baseline data were collected from different inpatient and outpatient departments in Shree Krishna Hospital (SKH), Karamsad. A total of 400 patients of geriatric age group (≥65 years) from various inpatient and outpatient departments of SKH were included in the study. Relevant information from patients included in the study was recorded in a structured proforma from their case files. Data were evaluated for appropriateness of prescribing by using both Beers criteria and Phadke's criteria and comparison between the two criteria was also carried out.Results:Out of total 400 patients, 291 (72.75%) patients were prescribed appropriately according to Beers criteria. Based on Phadke's criteria, 158 (39.5%) prescriptions were rational, 129 (32.3%) were semirational and 113 (28.3%) were irrational. Mean rationality score on a 30-point semiscientific scale was found to be 18.47 ± 9.66 (mean ± SD). The comparison of outcome by both the criteria showed no significant difference in appropriateness of prescribing (P>0.05).Conclusions:Inappropriate prescribing is common in elderly patients. Beers criteria is a well-established method for evaluating appropriateness of prescribing. This study has shown that Phadke's method of evaluating rationality of prescriptions compares equally well and hence can be a valuable objective tool for assessing appropriateness of prescribing in geriatric patients.

Drug prescribing patterns in elderly patients in a tertiary level hospital

“…The trend is similar to a study in elderly patients where 27.25% patients received one PIM and 4.65% drugs were inappropriate. 17 As the total number of drugs prescribed to patients increased there was a statistically significant increase in the number of PIMs received. There should also be mass awareness amongst physicians about rational use of drugs.…”

“…This was comparable to two similar studies. 17,18 where average number of drugs in elderly patients in I.P.D. was 7.30 and 7.73 respectively.…”

“…This was significantly lower than 36.8% in a study done by Shankar et al and 48.79% in another study in elderly done by Jhaveri et al 18,19 There is need to reinforce prescribing drugs by generic name as this will ultimately lead to rational use of drugs and reduce the cost to the patients. 17 Based on Beers criteria 2012, 118 out of 1311 (9%) of the drugs prescribed in O.P.D. were inappropriate.…”

Drug utilization pattern in sick paediatric patients: analysis for rationality and other aspects

“…7 In a similar study for geriatric patients (age ≥65 years) carried out by Geriatric patients at tertiary care teaching hospital, the mean rationality score was 18.47. 5 In prescription audit study done by In another studies; collecting prescriptions fro m general practitioners from public and private sectors, using same Phadke's criteria; the mean rationality score was 25.83 for public sector and 20.45 for private sector. 8 In another work reported average rationality score of 19.23 and 20.83 for prescription obtained from physician of teaching institute and private sector respectively.…”

“…In a study authors found, 39.5%, 32.3%, and 28.3% rational, semi-rational and irrational prescriptions respectively while in another study found, 53%, 30% and 17% prescriptions to be rational, semi-rational and irrational respectively. 5,7 When rationality score was calculated, 75 prescriptions had 25 score, 15 prescriptions had 26 score followed by 24 and 6 prescriptions in range of 15-21 score and 8-13 score respectively. Minimum score of 8 was observed in two prescriptions.…”