A Cross-Sectional Retrospective Study Assessing Potentially Inappropriate Medications for Elderly Diabetic Patients in a Tertiary Care Hospital in Saudi Arabia

Haifa A Fadil,1 Ziyad S Alrehaili,2 Khaled M Alharbi,3 Abdulaziz F Almuzaini,4 Raed Hamed Alharbi,4 Hindi S Alharbi,4 Hossein M Elbadawy,5,6 Yaser M Alahmadi1 1Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia; 2Medical and Pharmaceutical Services, Pharmacy Department, General Directorate of Medical Services Ministry of Interior, Riyadh, Kingdom of Saudi Arabia; 3Ambulatory Care Pharmacy Department, Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia; 4Pharmaceutical Care Department, King Salman Bin Abdulaziz Medical City, Madinah, Kingdom of Saudi Arabia; 5Department of Pharmacology and Toxicology, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia; 6Health and Life Research Center, Taibah University, Madinah, Saudi ArabiaCorrespondence: Haifa A Fadil, Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia, Email [email protected]: The aging global population presents challenges in medication management, particularly among diabetic elderly patients vulnerable to potentially inappropriate medications (PIM). PIM can lead to adverse outcomes like hypoglycemia, falls, cognitive decline, and hospitalizations, affecting quality of life and survival. This study aimed to assess PIM prevalence among diabetic elderly patients in a tertiary care hospital in Saudi Arabia, using the American Geriatrics Society 2023 Updated Beers Criteria.Methods: A cross-sectional retrospective study was conducted among 480 diabetic adults aged 60 years or older at a tertiary care hospital over 3 months. Data, including demographics, comorbidities, and medication use, were extracted from Electronic Health Records. 2023 AGS Updated Beers Criteria® was followed.Results: The median age was 66 years with a male predominance (62.7%). Peripheral vascular disease (42.7%) and prior myocardial infarction (22.7%) were prevalent comorbidities. Inappropriate insulin use was observed in 17.7% of insulin users, mainly short-acting insulin without basal/long-acting insulin. Approximately 39.2% of patients were prescribed antidiabetic drugs deemed inappropriate by Beers Criteria, with Gliclazide being the most common (35.6%). Despite potential drug–disease interactions, such as urogenital infections, half of the patients received cautioned drugs, while only 4.2% experienced such infections.Conclusion: The study highlights the prevalence of PIMs among diabetic elderly patients in Madinah, Saudi Arabia. Adherence to Beers Criteria guidelines is crucial to optimize therapy for this population. Age and congestive heart failure were significant predictors of PIM use.Keywords: beers criteria, elderly, diabetes, insulin, PIM, Saudi Arabia