Geriatric Prescription in a Nigerian Tertiary Hospital

Abstract

Objectives:To assess the medications prescribed for elderly inpatients on specific days during hospital admission with a view to detecting areas of irrational prescription.Methods:It was a prospective study of all patients aged 65 years and above admitted to the medical wards of a Nigerian tertiary hospital over a 12-month period. The World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) drug use indicators were used to assess drug prescriptions on various days of admission.Results:A total of 1513 patient encounters involving 345 patients aged between 65 and 92 years were assessed on hospital days 1, 3, 5, 7, 14, and 28. The average number of medicines per encounter ranged from 6.1 ± 2.5 on hospital day 1 to 7.8 ± 2.4 on hospital day 28. This difference was statistically significant (F = 14.42; P < 0.05). The percentage of encounters with an antibiotic prescribed ranged from 50.4% on hospital day 1 to 62.9% on hospital day 28 while the percentage of encounters with an injection prescribed decreased from 72.8% on hospital day 1 to 50.0% on day 28.Conclusions:This study suggests some degree of irrational prescribing as evident by the high average number of medicine per encounter and the high percentages of encounters with an antibiotic or injection prescribed. However, there is a need to develop standard values for the WHO/INRUD indicators based on the recently published national treatment guidelines for common elderly diseases which will serve as yardsticks to assess elderly inpatients prescriptions using WHO/INRUD core indicators in future studies.

Patient Factors Associated with Pharmaceutical Interventions for Inpatients at a Brazilian Teaching Hospital

“…22 Similar to our results, the major classes of medications prescribed at a Nigerian tertiary hospital were vitamins (82.9%), antibiotics for systemic use (72.8%), and analgesics (60.0%). 23 To the best of our knowledge, this is the first study in which electrolyte imbalance was significantly associated with the occurrence of pharmaceutical interventions. This finding reaffirms the need to correct serum electrolytes, especially given that such imbalances may be drug-related (e.g., diuretics, corticosteroids, laxatives, and angiotensin-converting enzyme inhibitors), to avoid negative clinical consequences such as muscle weakness, mental confusion, arrhythmias, ventricular fibrillation, and cardiac arrest.…”

Evaluating antimicrobial prescribing in a Tertiary Healthcare Institution in Nigeria

“…Previous studies [ 11 , 12 ] have evaluated the use of antibiotics in children visiting the out-patient pharmacy and among geriatric in-patients, but not in adults visiting the adult out-patient pharmacy. This information would add to the knowledge and understanding of the antibiotics utilization among the adult population visiting the out-patient pharmacy of a tertiary health institution in Nigeria.…”

Evaluation of One-Year Antibiotics Utilization in the Adult Outpatient Pharmacy of a Nigerian Tertiary Health Institution

“…Therefore, the objectives of this study were to evaluate the demographic characteristics of patients in the adult out-patient pharmacy of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, describe the antibiotics use pattern, determine the antibiotics prescriptions per encounter, determine if prescribed antibiotics are on essential drug list and determined the cost associated with antibiotics use in the study site. Previous studies in NAUTH [11,12], evaluated drug use in children in out-patient pharmacy and geriatric in-patients respectively. Additional knowledge on antimicrobials use in adult out-patient pharmacy will augment the understanding of antibiotic use in a typical Nigerian tertiary health institution and help develop standards for guidelines for antibiotic use process in teaching hospitals in Africa generally and Nigeria in particular.…”