Evaluation of the appropriateness of prescribing in geriatric patients using Beers criteria and Phadke's criteria and comparison thereof

OBJECTIVES: To evaluate appropriateness of prescribing medicines in geriatric patients using both Beers criteria and Phadke's criteria and compare them for validation of Phadke's criteria as a tool to evaluate rationality of prescribing in elderly. MATERIALS AND METHODS: A cross-sectional prospective observational study was conducted and the baseline data were collected from different inpatient and outpatient departments in Shree Krishna Hospital (SKH), Karamsad. A total of 400 patients of geriatric age group (≥65 years) from various inpatient and outpatient departments of SKH were included in the study. Relevant information from patients included in the study was recorded in a structured proforma from their case files. Data were evaluated for appropriateness of prescribing by using both Beers criteria and Phadke's criteria and comparison between the two criteria was also carried out. RESULTS: Out of total 400 patients, 291 (72.75%) patients were prescribed appropriately according to Beers criteria. Based on Phadke's criteria, 158 (39.5%) prescriptions were rational, 129 (32.3%) were semirational and 113 (28.3%) were irrational. Mean rationality score on a 30-point semiscientific scale was found to be 18.47 ± 9.66 (mean ± SD). The comparison of outcome by both the criteria showed no significant difference in appropriateness of prescribing (P>0.05). CONCLUSIONS: Inappropriate prescribing is common in elderly patients. Beers criteria is a well-established method for evaluating appropriateness of prescribing. This study has shown that Phadke's method of evaluating rationality of prescriptions compares equally well and hence can be a valuable objective tool for assessing appropriateness of prescribing in geriatric patients.