PP-4 Investigation of inappropriate medication use in elderly patients in internal medicine department using TIME criteria

<h3>Introduction</h3> Polypharmacy refers to the concurrent use of multiple medications, while inappropriate drug use occurs when patients take more medications than necessary or use drugs without proper indication. The elderly are particularly at risk due to age-related metabolic changes and decreased drug clearance. To address this, the TIME (Turkish Inappropriate Medication Use in the Elderly) criteria have been established to guide appropriate medication use in the Turkish population. <h3>Aims</h3> This study aims to assess polypharmacy and inappropriate drug use among elderly patients hospitalized in the internal medicine ward using the TIME criteria. The goal is to raise awareness and assist clinicians in preventing inappropriate drug use. <h3>Methods</h3> The study involved 151 patients aged 65 and older, admitted to the internal medicine department at Prof. Dr. Cemil Taşcıoğlu City Hospital between January and April 2024. Patients on five or more medications were considered as experiencing polypharmacy. Data such as prescribed medications, diagnoses, age, gender, and chronic diseases were extracted from the hospital’s electronic records. The TIME-to-STOP criteria were utilized to evaluate inappropriate drug use. <h3>Results</h3> Among the 151 elderly patients, 54.96% were female and 45.03% male. Most patients had chronic conditions, including hypertension (48.34%), diabetes mellitus (28.47%), and coronary artery disease (19.86%). All patients were classified as having polypharmacy, with 49% demonstrating inappropriate medication use. Proton pump inhibitors (PPIs) were the most commonly used (84.10%), with 32.28% inappropriate use. Notably, clopidogrel (22.22%) and furosemide (22.03%) also exhibited significant inappropriate use. <h3>Conclusion</h3> The high prevalence of inappropriate PPI use in elderly patients is largely due to multidrug usage. Clinicians should reconsider prescribing practices, accounting for potential adverse effects. <h3>Impact</h3> This study underscores the importance of using the TIME criteria to guide medication management in elderly patients, ultimately reducing the risks associated with polypharmacy. <h3>References</h3> Kim J, Parish AL. Polypharmacy and medication management in older adults. <i>Nurs Clin North Am</i>. 2017;<b>52</b>:457–68. Dagli RJ, Sharma A. Polypharmacy: a global risk factor for elderly people. <i>J Int Oral Health.</i> 2014;<b>6</b>(i–ii). Çavuşoğlu Ç. ‘TIME kriterleri ile belirlenen uygunsuz ilaç kullanımı ve kırılganlık arasındaki ilişki’. <i>Cukurova Medical Journal</i> 2022;<b>47</b>:1281–1289 Bahat G, Ilhan B, Erdogan T, Halil M, Savas S, Ulger Z, ... , Karan MA. Turkish inappropriate medication use in the elderly (TIME) criteria to improve prescribing in older adults: TIME-to-STOP/TIME-to-START. <i>European Geriatric Medicine</i> 2020;11:491–498. Kummer I, Reissigová J, Lukačišinová A, Ortner Hadžiabdić M, Stuhec M, Liperoti R, ... , Fialová D. Polypharmacy and potentially inappropriate prescribing of benzodiazepines in older nursing home residents. <i>Annals of Medicine</i> 2024;<b>56</b>(1):2357232.