Abstract
Introduction: Medication management in elderly patients is truly a challenge for all health care professionals. Age-related changes, poly-pharmacy, and co-morbidities are factors for Potentially Inappropriate Medications [PIMs] prescribing that will increase the risk of Adverse Drug Events [ADEs]. STOPP [Screening Tool of Older Persons' Prescriptions] criteria are the most updated screening tool for detecting PIMs in elderly patients.
Objectives: To estimate the proportion of potentially inappropriate medications among the elderly visiting Emergency Care Center [ECC] at King Abdul-Aziz Medical City-Central Region [KAMC-CR].
Methods: Prospective cross-sectional study has been approved by the Institutional Review Board. The study includes 300 patients, conducted over two months from October-November 2014 at an ECC in KAMC-CR. The inclusion criteria: elderly more than 60 years old, patients from both gender and have polypharmacy [more than 4 medications] prescription. Exclusion criteria: patients who are non-eligible to be treated in KAMC-CR, and who don't have medications history in KAMC-CR pharmacy computer system. The data were collected from the hospital electronic system and patients' charts. The statistical analysis was completed using the Statistical Package for the Social Sciences [SPSS] 19.0 software. Results will be reported in terms of frequency, percent, and p-value.
Results: 1200 patients who were admitted in ECC at KAMC-CR conducted over two months from October-November 2014. As a result, our study consisted of 300 patients [male 54% female 46%], the majority of patients were between 60-79 years old. PPIs are prescribed to 206 out of 300 patients. The results showed that the most frequent prescriptions resulting in PIPs by STOPP criteria were the PPI [20%], duplicated drug class prescriptions and long-term opiates in those with recurrent falls [11.7%] and vasodilator drugs with postural hypotension [11.4%].
Conclusion:
Poly-pharmacy was independently associated with PIMs especially in patients aged over 65.
These findings have significant implications that will help us identify areas of improvement in the overall medical care of geriatric patients and focus on avoiding inappropriate drug use, reduce unnecessary medication, drug interactions and related adverse events.
Comparing with other international findings, our institutions need to pay more attention to prescribing in the elderly population.