Author/Authors :
Kargar , Mona Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran , Atrianfar , Fatemeh Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran , Rashidian , Arash Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran , Heidari , Kazem Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran , Noroozian , Maryam Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran , Gholami , Kheirollah Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran , Javadi , Mohammad Reza Research Center for Rational Use of Drugs - Tehran University of Medical Sciences - Tehran, Iran
Abstract :
The world’s population is growing older. Inappropriate and irrational use of drugs in the elderly is a considerable
health concern due to consequences such as increased morbidity and adverse drug events. This study aimed to evaluate the rationality
of prescribing and determining the extent of inappropriate prescribing in a sample of geriatric patients in Tehran.
Methods: This cross sectional study was performed on 1512 prescriptions of patients aged ≥ 65 years from 5 pharmacies affiliated to
Tehran University of Medical Sciences in 2014. Prescription of potentially inappropriate medications (PIMs) was investigated using
the Beers Criteria along with WHO prescribing indices. Date were analyzed using SPSS software, and significance level was set at less
than 0.05.
Results: Mean (SD) age of patients was 73.9(6.7) years. A total of 472 (31.2%) patients received at least 1 PIM. Benzodiazepines
were the most frequent drug class and general practitioners (GPs) were the most frequent prescriber of PIMs. The highest and the
lowest percentage of prescriptions containing brand-names were prescribed by subspecialists (62.5%) and GPs (42.2%), respectively.
Antibiotics and injectable medications were prescribed for 26.8% and 28.5% of patients by GPs. Mean (SD) number of drugs per
prescription was 3.57 (1.92). Prescriptions containing systemic antibiotics and PIMs had significantly higher mean number of drugs
compared to those without these items (both P < 0.001).
Conclusion: There is a need for interventions to improve the quality of prescribing for elderly patients, especially by GPs. Also,
there are still some problems in rational use of drugs based on prescribing indices, especially, prescribing brand-names and injectable
medications.
Keywords :
Inappropriate prescribing , Drug prescriptions , Beers criteria , potentially inappropriate medication list , World Health Organization prescribing indices , Antibacterial agents , Aged Injections