Appropriateness of prescribing in elderly patients attending a tertiary care teaching hospital according to STOPP-START criteria

OBJECTIVES: To determine the frequency and pattern of potentially inappropriate prescriptions, including potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), among elderly inpatients aged 65 years and above in a tertiary care hospital. METHODS: This hospital-based observational Cross-sectional study was conducted from January 2019 to January 2020 in the Medicine Department. Four hundred patients aged ≥65 years with at least one chronic illness and complete medication records were included. The STOPP/START version 2 criteria were applied to identify PIMs and PPOs. Demographic details, clinical diagnoses, and hospitalization data were collected and analyzed. RESULTS: Among 400 patients (233 men, 167 women; mean age 69 ± 4.94 years), cardiovascular diseases were the most common cause of admission (30 %), followed by respiratory (21 %) and nervous system disorders (12.5 %). A total of 4,337 medications were prescribed, averaging 10.87 per patient. PIMs were identified in 48 patients (12 %), most frequently cardiovascular drugs (36 %), fall-risk-increasing drugs (16 %), and antiplatelet/anticoagulant agents (13 %). PPOs were observed in 38 patients (9.5 %), commonly involving cardiovascular and preventive therapies. CONCLUSIONS: Inappropriate prescribing remains prevalent among elderly inpatients. Routine use of structured tools such as STOPP/START may enhance safer, evidence-based prescribing and improve outcomes.