Assessing potentially inappropriate medications use among Pakistani geriatric patients based on 2019 Beer's Criteria: A cross-sectional study

Introduction: Geriatric patients frequently develop drug-related problems due to alterations in age-related pharmacokinetics and pharmacodynamics. Consequently, selecting an appropriate pharmacotherapy for older adults is challenging. Furthermore, potentially inappropriate medications (PIMs) in such patients are associated with adverse health consequences, repeated hospitalization, and a higher risk of mortality. This study assessed the PIMs based on the 2019 Beer’s Criteria among hospitalized geriatric patients. Methodology: An observational cross-sectional study was conducted in two hospitals of Abbottabad. Hospitalized patients aged ≥60 years were included in the study. Patients who were at the end of their lives and in intensive care units were excluded. PIMs were identified using Beer’s Criteria 2019, while potential drug-drug interactions were identified using a Drug-interaction checker. Results: Out of 100 geriatric patients’ prescriptions, males (71%), age range 65-70 years (58%), and patients having intermediate education (34%) were predominant. Approximately, 83% of patients received PIMs, of which, 63% received PIMs of category A. Omeprazole (42%), dexamethasone (18%), and aspirin (16%) were frequently prescribed PIMs. Polypharmacy and pDDIs were observed in 38% and 37% of prescriptions, respectively. Total of 17 prescriptions had major pDDIs. No statistically significant association was observed for PIMs use with patient characteristics i.e., age, gender, and hospital stay. Conclusion: This study identified a high prevalence of PIMs, polypharmacy, and pDDIs. Omeprazole is a commonly identified PIM, while category A PIMs are frequently detected. Geriatric patients' prescriptions should be thoroughly reviewed for any possible inappropriate medicines and DDIs so that rational medicines can be provided to such patients.