SIGNIFICANT ROLE OF CLINICAL PHARMACISTS IN THE ASSESSMENT OF INAPPROPRIATE MEDICATIONS PRESCRIBED TO THE ELDERLY PATIENTS IN A UNIVERSITY TEACHING HOSPITAL
The elderly people experience a higher incidence of diseases, physical impairment, medication use, and adverse drug effects than younger adults therefore care must be taken while prescribing the drugs in this group. The present study was under taken by the clinical pharmacists of a tertiary care teaching hospital with the aim of assessing the potentially inappropriate medications (PIMs) in the elderly patients by comparing with the American Geriatric Society (AGS) 2012 updated Beers criteria. This clinical tool was developed to improve the care of older adults by reducing their exposure to potentially inappropriate medications .The criteria consist of medications in which the risk out weights the benefits. During the study period of six months a total of 203 patients were enrolled. It includes 121 (59.6%) males and 82 (40.4%) female patients. The mean ages of the patients were 70 years Â± 2.480 S.D. The mean medication prescribed per patient was 7.08 Â±2.480 S.D. The patients had an average stay of 14.58 days in the hospital with a range of one to three weeks stay .There were 76 (37.4%) inappropriate prescriptions and 127 (62.6%) appropriate prescriptions as per the Beerâ€™s criteria. The common inappropriate drugs prescribed included NSAIDâ€™s (20.19%), Anxiolytics (13.79%), Antidepressants (5.41%), Antihypertensive (3.94%), Antispasmodics (2.65%), Anticonvulsants (1.97%), Sedative and hypnotics (1.47%), Antihistamines (0.98%), Antidiabetics (0.98%), and Antibiotics (0.98%). Polypharmacy and the duration of hospital stay were identified as risk factors for inappropriate medication. The study proved that clinical pharmacist can contribute his skill and knowledge to achieve better therapeutic outcomes in the patients.
Key words: Potentially inappropriate medications, Elderly patients, Clinical pharmacist, Beers Criteria
2. Robin J Harman, Pamela Mason, Hand book of pharmacy health care, 2nd edition:Pharmaceutical Press;2002.348-356.
3. Montamat SC, Cusack BJ, Vestal RE. Management of drug therapy in the elderly. N Engl J Med 1989; 321:303-309.
4. Lau DT, Kasper JD, Potter DE, Lyles A, Bennett RG.Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents.Arch Intern Med. 2005;165(1):68-74.
5. Lund BC, Steinman MA, Chrischilles EA, KaboliPJ.Beers criteria as a proxy for inappropriate prescribing of other medications among older adults.AnnPharmacother. 2011;45(11):1363-70.
6. Dhall J, Larrat EP and Lapane KL. Use of potentially inappropriate drugs in nursing homes. Pharmacotherapy 2002; 22 (1): 88-96.
7. Hanlon JT, Horner RD, Scmader KE et al. Benzodiazepine use and cognitive function among community dwelling elderly. ClinPharmacolTher 1998; 64:684-692.
8. Beers MH, Ouslander JG, Rollingher I, et al. Explicit criteria for determining inappropriate medication use in nursing home residents. Arch Intern Med. 1991 Sep;151(9):1825-32.
9. Joris C. Verster, Edmund R. Volkerts. Antihistamines and driving ability:evidencefrom on-the-road driving studies during normal traffic. Ann Allergy Asthma Immunol. 2004;92:294â€“304.
10. Beers MH and Ouslander JG. Risk factors in geriatric drug prescribing: A practical guide to avoiding problems. Drugs 1989; 37: 105-112.
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