Inappropriate Prescribing in Elderly Inpatients at a University Hospital in Saudi Arabia

BACKGROUND AND OBJECTIVES: Elderly populations usually use more medications than any other age group and are therefore more susceptible to potentially inappropriate prescribing (PIP), drug–drug interactions, and the related health consequences. In this study, we aimed to determine PIP prevalence and explore the most common potentially inappropriate medications (PIMs) prescribed. METHODS: This was a retrospective study involving elderly patients admitted at King Abdulaziz Medical City-Jeddah (KAMC-JD), between November 2014 and January 2015. We included all elderly patients aged 60 years and above admitted to KAMC-JD through the emergency department (ED), clinic, and direct admissions during the study period. Patients admitted to the intensive care unit, oncology department, and/or those who passed way in the ED before admission were excluded from the study. Prescriptions were assessed for PIP using the 2012 Beers Criteria, which categorizes PIMs to three classes: first class are medications to avoid in older adults regardless of their conditions; second class are medications to avoid with certain diseases or syndromes; and third class are medications that should be used with caution. RESULTS: Our study included 135 patients, of which 49.6% were males. The mean age was 71.26 ± 8.1 years. According to the 2012 Beers Criteria, 80% of patients were using at least one listed PIM. For the Criteria’s first, second, and third classes, PIM prescription rates were 72.6%, 59.2%, and 37.7%, respectively. Regarding the most prescribed PIM in each class, insulin (sliding scale) was the most reported PIM in the first class, NSAIDs in the second class, and, lastly, vasodilators in the third class. CONCLUSION: PIP is a serious health issue threatening elderly patients. There is a need to develop evidence-based, context-sensitive, and user-friendly tools to assess PIP, as well as supportive training programs.