Prescribing of Potentially Inappropriate Medications to ElderlyPeople by Medical Specialists in Isfahan, Iran Inappropriate prescription
Iranian Journal of Pharmaceutical Sciences,
Vol. 4 No. 4 (2008),
1 Mehr 2008
,
Page 241-246
https://doi.org/10.22037/ijps.v4.41040
Abstract
The goal of this study is to identify the types of potentially inappropriate drugs prescribed by the medical specialists of Isfahan province to elderly patients. A number of 31,254 randomly selected prescriptions from medical specialists of Isfahan province were reviewed for elderly patients who were insured by the Social Security Organization. Three thousand and seven prescriptions were identified and Beers'Criteria was applied to figure out the type of inappropriate medications. The study concluded 49% males and 51% females. Sixty one percent of patients were 65-74 years old and 39% older than 74 years old. Of all the prescriptions reviewed, 24.4% contained inappropriate medications. The ten most common medications detected in the prescriptions were: Naproxen (18.4%), fluoxetine (8.3%), clidinium C (7.2%),indomethacin (7.2%), chlordiazepoxide (5.8%), doxepin (4.76%), dipyridamole (4.4%), amitriptyline (4.27%), methocarbamol (4.15%) and piroxicam (3.88%). Theresults are comparable to what has been reported in the literature. This is also inaccordance with the national drug consumption as NSAIDs are heavily usedthroughout Iran. Due to the extent of inappropriateness of medicine use in the elderly population, we need to define a strategy to curtail this problem including educational classes for physicians and launching national geriatrics residency programs.
- Beers' criteria
- Elderly
- Inappropriate medication
- Prescription
How to Cite
References
[2]Mcload PJ, Huang AR, Tamblyn RM,Gayton.Defining inappropriate practices in prescribing for elderly people: National consensus panel. CMAJ 1997; 156: 385-91.
[3]Oborne CA, Batly GM, Makery V, Swift CG, Jackson SH. Development of prescribing indicators for elderly medical inpatients. Br JClin Pharmacol1997; 43: 91-7.
[4]Beers MH, Ouslander JG, Rollinger I, Reuben DB, Brock J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLAdivision of geriatric medicine.Arch Intern Med1991; 151: 1825-32.
[5]Habson M. Medications in older patients. West J Med1992; 157: 539-43.
[6]Tinett ME , Bogardus ST, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med2004; 351:2860-74.
[7]Beers MH. Explicit criteria for determining potentially inappropriate medication use by the elderly: An update. Arch Intern Med1997; 13:1531-6.
[8]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 Med2003; 59: 2716-24.
[9]Niwata S, Yamada Y, Ikegami N. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities. BMC Geriatr2006; 6: 1-4.
[10]Piecoro LT, Brownings SR, Prince TS, Ranz TT ,Scutchfield FD. Adata based analysis of potentially inappropriate use in an elderly medicaid population. Pharmacotherapy2000;20: 221-8.
[11]Fick DM, Waller JR, Maclean JR, Heurel RV,Tadlock JG. Potentially medication use in a medicare managed care population: Association with higher costs and utilization. J Managed Care Pharm2001; 7: 407-13.[12]Egger SS, Bachmann A, Hubman N, Schlhenger RG, Kerahen buchi S. Prevalence of potentially inappropriate medication use in elderly patients:Comparison between general medical and geriatric wards. Drug Aging2006; 23: 823-7.
[13]Stuck AE, Beers MH ,Steiner A, Aronow HU ,Rubenstein LZ, Back JC. Inappropriate medication use in community-residing older persons. Arch Intern Med1994; 154: 2195-200.
[14]Apprasu RR, Fliginger SE. Inappropriate medication prescribing for the elderly by office-based physicians.Ann Pharmacother1997; 31:823-9.
[15]Apprasu RR, Stizman SJ. Inappropriate prescribing for elderly outpatients. Am J Health Sys Pharm1999; 56: 433-9.
[16]Hanln JT, Fillenbaum G, Schmader KE ,Kuchibhatha M, Horner RD. Inappropriate drug use among community dwelling elderly. Pharma-cotherapy2000; 20: 575-82.
[17]Chang CM, Liu Oy, Yang Yh, Wu CF, Lu FH.Potentially inappropriate drug prescribing among first-visit elderly outpatients in Taiwan. Phar-macotherapy2004; 24: 843-55.
[18]Howard M, Dolovich L, Kaczorowski J, SellorsC, Sellors J. Prescribing of potentially inappropriate medications to elderly people.Family Practice2004; 21: 244-7.
[19]Ay P, Akici A, Harmane H. Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, Turkey. Int J Clin Phamacol Ther2005; 43: 195-202.
[20]Simon S, Chan KA, Soumerai SB, Wanger AK,Andrade SE, Feldstein AC, Davis RL, Guatwitz JH. Potentially inappropriate medication use by elderly persons in U.S Health Maintenance Organisation 2000-2001. J Am Soc2005; 53:227-32.
[21]Azoulay L, Zargarzadeh A, Salahshouri Z,Ovarichi D, Berard A. Inappropriate medication prescribing in community-dwelling elderly people living in Iran.Eur J Clin Pharmacol 2005; 61;913-9.
[22]Maio V, Hartman CW, Poston S, Liu-Chen ,Diamond J, Arenson C. Potentially inappropriate prescribing for elderly patients in 2 outpatient settings. Am J Med Qual2006; 27: 162-8.
[23]Apprasu RR, Mort JR. Inappropriate prescribing for the elderly: Beers' criteria - based review.Annals Pharmacother2000; 34: 338-43.
[24]Willcox SM, Himmelstein DU, Woolhancller S.Inappropriate drug prescribing for the community dwelling elderly. JAMA1994; 272: 292-6.245
- Abstract Viewed: 287 times
- IJPS_Volume 4_Issue 4_Pages 241-246 Downloaded: 219 times