PRESCRIBING PATTERN IN GERIATRIC PATIENTS IN MEDICAL OPD OF A TERTIARY CARE TEACHING HOSPITAL
Objectives: Geriatric population is increasing globally and they suffer from multiple disorders necessitating administration of number of drugs. The objective of the present study was to examine the prescribing pattern in geriatric patients in a medical OPD.
Methods: An observational, cross-sectional study was conducted in medical OPD of Government Medical College, Jammu, over a period of a month after approval of the Institutional Ethics Committee. Patients above 65 years of age who gave consent were included in the study. The prescriptions were analyzed for demographic profile (age and gender), average number of drugs per prescription, drugs by generic or brand names, fixed drug combinations (FDCs), and percentage of potentially inappropriate as per Beers criteria.
Results: A total of 200 patients were included comprised 64% of males and 36% of females. The most of patients were in the age group of 65–69 years (37.5%). A total of 200 prescriptions contained 1128 drugs amounting to average 5.64 number of drugs per prescription. Maximum prescriptions had 1–5 drugs (61%) followed by 6–10 drugs (38.5%). Majority of drugs were prescribed by brand name (93.26%) and only 6.73% of drugs were prescribed by generic name. About 10.46% FDCs were prescribed. Maximum drugs prescribed were from respiratory system (20.3.1%), followed by GIT (18.4%), antimicrobials (17.2%), cardiovascular (10.99%), NSAIDs (9.3%), and vitamins (8.4%). Forty-one drugs (20.5%) in patients were potentially in appropriate drugs based Beers criteria and belonged mostly to anticholinergic, antihistaminic, sedatives, NSAIDs, and H2 blockers.
Conclusions: The present study demonstrates that polypharmacy and potentially inappropriate medication are still present in OPD prescription of geriatric population. Generic prescribing still lacks. Application of Beers criteria and increasing awareness about polypharmacy should be encouraged.
2. United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects (2008 Revision); 2008. Available from: http://www.esa.un.org/unpp/index.asp?panel=2.
3. Hayes BD, Klein-Schwartz W, Barrueto F Jr. Polypharmacy and the geriatric patient. Clin Geriatr Med 2007;23:371-90.
4. The State of Health and Aging in America 2004-CDC, Merck Institute of Aging and Health and Centers for Disease Control; 2004. Available from: https://www.cdc.gov›aging›pdf›state_of_aging_and_health.
5. Woodruff K. Preventing polypharmacy in older adults. Am Nurse Today 2010;5:1. Available from: http://www.americannursetoday.com/ preventing-polypharmacy-in-older-adults.
6. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007;5:345-51.
7. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2019;67:674-94.
8. Veena DR, Padma L, Patil S. Drug prescribing pattern in elderly patients in a teaching hospital. J Dent Med Sci 2012;1:39-42.
9. Oztürk GZ, Ardiç C, Toprak D. Frequency of polypharmacy and use of potentially inappropriate medications in the elderly. Turk J Geriatr 2017;20:296-5.
10. Bhaveshaikh N, Sukumaran S, Vyas U. Drug prescribing patterns in elderly patients in a tertiary level hospital. Int J Basic Clin Pharmacol 2017;6:759-64.
11. Khjauria V, Tandon VR, Rani N, Gilllani Z, Gupta S, Choudhary S, et al. Profile of adverse drug reactions with fixed drug combinations: How big is the problem? JK Sci 2015;17:33-7.
12. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr 2017;17:230.
13. World Health Organization. A Glossary of Terms for Community Health Care and Services for Older Persons. In Aging and Health Technical Report. It is Public Health and Economic Issue. Geneva: World Health Organization; 2004.
14. Nataraj GR, Bharathi DR. A study on prescribing pattern in geriatric patients. Asian J Pharm Clin Res 2019;12:120-3.
15. Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi CB. Drug utilization pattern and pharmacoeconomic analysis in geriatric medical in-patients of a tertiary care hospital of India. J Pharmacol Pharmacother 2014;5:15-20.
16. Chitra B, Senthilvel N, Sowmya R, Sathyan S, Srisha R. A study on prescribing pattern of drugs in geriatrics using beers criteria at a private corporate hospital. Int J Pharm Sci Res 2015;6:4810-25.
17. Kruse W, Rampmaier J, Frauenrath-Volkers C, Volkert D, Wankmüller I, Micol W, et al. Drug-prescribing patterns in old age. A study of the impact of hospitalization on drug prescriptions and follow-up survey in patients 75 years and older. Eur J Clin Pharmacol 1991;41:441-7.
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