A prospective observational study on geriatric and pediatric prescribing patterns, medication adherence, and cost analysis in a tertiary care hospital

BACKGROUND: Pediatric and geriatric patients are at risk of adverse drug effects as a consequence of age factors on pharmacokinetics, multimorbidity, and multicomplicated therapy regimens. The purpose of this study was to assess the quality of prescriptions as far as adherence and pharmacoeconomic burden are concerned in these vulnerable groups. OBJECTIVES: To evaluate the prescribing patterns, polypharmacy, and Potentially inappropriate medications (PIMs) use, medication adherence, drug-drug interaction, and direct medication expenditure in pediatric and geriatric patients in a tertiary care unit. MATERIALS AND METHODS: This was a six-month prospective observational study on major clinical departments. The World Health Organization prescribing indicators, 2019 Beers Criteria, and Morisky Medication Adherence Scale-8 (MMAS-8) adherence scale were used to evaluate the prescriptions. A pharmacoeconomic study was also conducted by comparing the direct medication costs of prescription of brand and generic medicines. Descriptive statistics were used in analyzing data. RESULTS: 604 patients were used (432 geriatric and 172 pediatric). The average number of drugs per prescription was 3.82. The percentage of prescriptions in generic form was 39.2%, and injectable prescriptions accounted for 41.2%. Polypharmacy was noted in 35.4% geriatric patients, and PIMs were 20.6% of prescriptions. Medication adherence was only found to be high in 21.5% of the patients, with forgetfulness being the most prevalent reason for nonadherence. The cost analysis based on pharmacoeconomics indicated the possible cost savings of about 60.8% by substituting the generic. CONCLUSIONS: The improvement of the situation in the geriatric and pediatric population could be achieved through the enhancement of the rational prescribing and generic-first policies.