• Lakhimi Borah Gauhati medical college
  • Diptimayee Devi gauhati medical college
  • Prasanjit Kumar Debnath Gauhati Medical college
  • Dibyajyoti Deka gauhati medical college


Objective: To investigate the drug utilization pattern and the prevalence of potentially inappropriate medications (PIMs) using updated AGS Beers criteria 2012 among the elderly patients who attended the geriatric outpatient departments as well as admitted  indoor patients ina tertiary care Hospital at Guwahati, Assam, India.

Method: A hospital based prospective, observational and cross sectional study, involving patients aged 65 years and above was planned and conducted over a period of 6 months from January 2016 to June 2016. Patients were visited daily, interviewed and case records were collected. Data were analyzed using Microsoft Office Excel Sheets.

Results: A total of 150 patients aged 65 years and above were analyzed. 97 patients (65%) were males and 53 (35%) were females. Majority of the patients (61 numbers, 41%) belonged to the age group of 65-70 years, and least were in the age group of 86-90 years (13 numbers, 9%). Prescription of five or more medications (polypharmacy) was observed in 117 (78%) patients. Majority of the patients presented with diseases of cardiovascular system (25.7%). Using WHO drug use indicators, the average number of drugs per prescription was found to be 5.6. The percentage of drugs prescribed by generic name was 86%. The percentage of encounters in which antibiotics were prescribed was  61%. Injection was prescribed was 65% cases and the percentage of drugs prescribed from the NLEM (National List of Essential Medicines of India) was 96%.  43 patients received PIMs from Beers list; majority were belonging to category 1. Spironolactone was most commonly prescribed PIM.

Conclusion:  Irrational prescribing practices and polypharmacy were detected in our study.

Prescribers should be educated about rational use of drugs and Beers criteria for elderly. 

Keywords: Beers criteria, WHO prescribing indicators, Potentially inappropriate medications, Elderly patients, Polypharmacy

Author Biographies

Lakhimi Borah, Gauhati medical college

Assistant Professor,

Department of Pharmacology

Diptimayee Devi, gauhati medical college

associate professor,

department of pharmacology

Prasanjit Kumar Debnath, Gauhati Medical college


Department of Pharmacology

Dibyajyoti Deka, gauhati medical college

PG trainee,

department of pharmacology


1. Shahet SN. API Textbook of Medicine. 8th ed., Vol. 2. Washington, DC: Munjal; 2003. p. 1578-80.
2. Upadhyay J, Joshi Y. Observation of drug utilization pattern and prevalence of diseases in elderly patients through home medication review. Asian J Pharm Clin Res 2011;4(1):143-5.
3. World Health Organization. Introduction to Drug Utilization Research.
Geneva: World Health Organization; 2003.
4. Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York: McGraw Hill; 2008. p. 57-66.
5. Chanana HB, Talwar PP. Aging in India: Its socioeconomic and health implications. Asia Pac Popul J 1987;2(3):23-38.
6. Age Care Statistics. Available from: http://www.helpageindia.com.
7. Reddy P, Gosavi D, Varma SK. An overview of geriatric pharmacology.
Asian J Pharm Clin Res 2012;5(4):25-9.
8. Zaveri HG, Mansuri SM, Patel VJ. Use of potentially inappropriate medicines in elderly: A prospective study in medicine out-patient department of a tertiary care teaching hospital. Indian J Pharmacol
9. Klotz U. Pharmacokinetics and drug metabolism in the elderly. Drug
Metab Rev 2009;41(2):67-76.
10. Corsonello A, Pedone C, Incalzi RA. Age-related pharmacokinetic and pharmacodynamic changes and related risk of adverse drug reactions. Curr Med Chem 2010;17(6):571-84.
11. Gorzoni ML, Fabbri RM, Pires SL. Potentially inappropriate medications in elderly. Rev Assoc Med Bras 2012;58(4):442-6.
12. Rochon PA, Gurwitz JH. Drug therapy. Lancet 1995;346(8966):32-6.
13. Helldén A, Bergman U, von Euler M, Hentschke M, Odar-Cederlöf I, Ohlén G. Adverse drug reactions and impaired renal function in elderly patients admitted to the emergency department: A retrospective study. Drugs Aging 2009;26(7):595-606.
14. Hogerzeil HV, Bimo, Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, et al. Field tests for rational drug use in twelve developing countries. Lancet 1993;342(8884):1408-10.
15. WHO. How to Investigate Drug Use in Health Facilities: Selected Drug
Use Indicators, WHO/DAP/93.1. Geneva: WHO; 1993.
16. Kanagasanthosh K, Topno I, Aravindkumar B. Prevalence of potentially inappropriate medication use and drug utilization pattern in elderly patients: A prospective study from a tertiary care hospital. Int J Res Med Sci 2015;3(8):2062-72.
17. Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly. An update. Arch Intern Med
18. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH.
Updating the Beers Criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Arch Intern Med 2003;163(22):2716-24.
19. American Geriatrics Society 2012 Beers Criteria Update Expert Panel.
American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc
20. Available from: http://www.pharmaceuticals.gov.in/nlem.pdf.
21. Shah RB, Gajjar BM, Desai SV. Drug utilization pattern among geriatric patients assessed with the anatomical therapeutic chemical classification defined daily dose system in a rural tertiary care teaching hospital. Int J Nutr Pharmacol Neurol Dis 2012;2(3):258-65.
22. Nayaka SR, Rajeshwari B, Venkatadri TV. Drug utilization pattern in geriatric inpatients of medicine department in a Tertiary Care Teaching Hospital. Int J Basic Clin Pharmacol 2015;3(4):568-73.
23. Haider SI, Johnell K, Weitoft GR, Thorslund M, Fastbom J. The influence of educational level on polypharmacy and inappropriate drug use: A register-based study of more than 600,000 older people. J Am Geriatr Soc 2009;57(1):62-9.
24. Polypharmacy in Elderly Patients (PDF). Available from: http://www. vumc.nl. [Last retrieved on 2015 Jan 16].
25. Isah AO, Ross-Degnan D, Quick J, Laing R, Mabadeje AF. The development of standard values for the WHO drug use prescribing indicators. ICUM/EDM/WHO. Available from: http://www.archives. who.int/prduc2004/rducd/ICIUM_Posters/1a2_txt.htm.
26. Vlahovic-Palcevski V, Bergman U. Quality of prescribing for the elderly in Croatia-computerized pharmacy data can be used to screen for potentially inappropriate prescribing. Eur J Clin Pharmacol 2004;60(3):217-20.
27. Gallagher P, O’Mahony D. STOPP (Screening Tool of Older Persons’potentially inappropriate Prescriptions): Application to acutely ill elderly patients and comparison with Beers’ Criteria. Age Ageing
443 Views | 367 Downloads
How to Cite
Borah, L., D. Devi, P. Debnath, and D. Deka. “A STUDY OF DRUG UTILIZATION PATTERN OF THE GERIATRIC PATIENTS IN THE DEPARTMENT OF GERIATRIC MEDICINE IN A TERTIARY CARE HOSPITAL IN ASSAM, INDIA”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 2, Feb. 2017, pp. 122-6, doi:10.22159/ajpcr.2017.v10i2.14762.
Original Article(s)