Point prevalence of drug prescriptions for elderly and non-elderly inpatients in a teaching hospital

Abstract

CONTEXT: Age-related pharmacokinetic and pharmacodynamic changes have been extensively documented, and several concurrent diseases may underlie multiple drug therapy in the elderly. As a result, the risk of adverse drug reactions and drug interactions increases among aged patients. However, only a few studies have compared the prescribing patterns for different age groups of hospitalized patients or have evaluated the effect of age on drug prescription. OBJECTIVE: To compare the prevalence of drug prescriptions for elderly inpatients, with those for non-elderly inpatients, in order to assess age-related differences in the number of prescribed drugs, drug choices and prescribed doses, and to evaluate the prescription appropriateness for the elderly patients. TYPE OF STUDY: Cross-sectional survey. SETTING: 400-bed tertiary care general teaching hospital. PARTICIPANTS: All inpatients on one day of June 1995, except for the Intensive Care Unit and for the Departments of Psychiatry, Pediatrics and Obstetrics and Gynecology. PROCEDURES: All medicines prescribed to the eligible patients on the study day were recorded from the prescription sheets provided by the hospital pharmacy. MAIN MEASUREMENTS: Name, therapeutic class, and mean daily dose of the prescribed drugs. RESULTS: Of the 273 eligible inpatients, 46.5% were 14-44 years old, 33% were 45-64 years old and 20.5% were > 64 years old. Cancer was significantly more frequent among the elderly. The mean number of prescribed drugs was five for all age groups. The five most prescribed drugs for all patients were dipyrone, ranitidine, dipyrone in a fixed-dose combination, metoclopramide and cefazolin. The elderly had significantly more prescriptions for insulin, furosemide and enoxaparin. For most drugs, the mean prescribed dose showed that there was no dose adjustment for elderly patients, and drug choices for this age group were sometimes questionable. CONCLUSIONS: There was little variation in the prescribing patterns for the elderly when compared with the other age strata.

Drug utilization pattern in geriatric inpatients of medicine department in a Tertiary Care Teaching Hospital

“…17 Average number of drugs per prescription was 7 (1050/150) which shows polypharmacy while it was 5.51 (1296/235) in Sharma et al 16 study and 5 in another study in Brazil. 18 The reason for polypharmacy in geriatric patients is coexistence of more than one comorbid conditions. Considering the adverse outcomes associated with polypharmacy, including adverse drug events, drug-drug interactions, increased cost of medications and/or treatment, increased risk of hospitalization, patient nonadherence with treatment (which increases with complex regimens), and various medication errors, we need to take appropriate measures for minimizing polypharmacy.…”

“…This coincides with the findings of other studies from India, which have also shown highest use of Group A (alimentary and metabolism) drugs according to the ATC classification system. 22 Though it is the most frequently prescribed drug, the prevalence of gastrointestinal 18 has also reported Group A (ranitidine) as one of the most frequently prescribed medicines despite the low prevalence of gastrointestinal conditions. This shows that the irrational use of Group A drugs is common.…”

Ranitidine Prescription Pattern of Outpatient in a Public Hospital in Al-Kharj

“…Braga et al stated that among inpatients in a teaching hospital, the five most commonly prescribed drugs were dipyrone, ranitidine, metoclopramide, dipyrone in a fixed-dose combination and cefazolin. They also stated that there was a high prevalence of ranitidine prescription (42.9%), but it is noteworthy that only 10.7% had digestive diseases [14]. Additionally, Nidhi et al reported that in an orthopedic department, ranitidine was most frequently prescribed, followed by aspirin, diclofenac sodium and amlodipine [15].…”

Descrição da atuação do farmacêutico em equipe multiprofissional com ênfase no cuidado ao idoso hospitalizado

“…Cruciol-Souza et al, 31 ao avaliarem as prescrições medicamentosas em um hospital universitário brasileiro, detectaram que a metoclopramida estava entre os 10 medicamentos mais prescritos. Braga et al 32 também detectaram fato semelhante: a metoclopramida esteve entre um dos cinco medicamentos mais prescritos em um hospital universitário brasileiro. Observa-se, muitas vezes, que a metoclopramida é prescrita como um medicamento "se necessário", ou seja, apenas se o paciente apresentar náuseas ou vômitos esse medicamento será utilizado.…”