Abstract

A STUDY OF PRESCRIPTION PROVIDED TO THE ELDERLY; USING WHO PRESCRIBING INDICATORS AND BEERS CRITERIA

Nischit Nepal*, Shabnam Ara, Nishant Saba, Suvarnna S., Amish Uprety* and

Abstract

Background: The elderly population is growing rapidly worldwide. Inappropriate prescribing elderly can cause substantial morbidity and result in clinical burden to patient. Gaining insight into physician prescribing pattern to recognize prescribing problem is the fundamental first step in trying to improve the quality of prescribing. Aims and Objective: To assess the drug utilization pattern and analyze the prescriptions using who prescribing indicator and beer’s criteria 2019 among the elderly patients attending inpatient department of a tertiary care hospital. Materials and Methods: A prospective study was conducted at a in-patient department of a tertiary care over a time period of 6 months. All the in-patients aged 65 years and above were included in the study. WHO core prescribing indicators was used to analyze the prescriptions and PIMs were identified using beer’s criteria. For the drug utilization aspect of the study the data was collected in structured data collection form which include sex, age, diagnosis, IP number and complete prescription which included the prescribed drugs and dosages. The data obtained were tabulated and analyzed to meet the needs of the objective set forth in the study using Microsoft excel and IBM SPSS statistics version 23 software. Results: A Total of 151 patients aged 65years and above were involved in our study. Among 151 patients, 74(49%) were male and 77(51%) were female. The majority of the patients were in the age group 65-69(70.86%) followed by age group of 70-74 years were (11.92%), 75-79 years were (5.96%), 80-84 years were (6.62%) and the lowest number of patients were in the age group of 85+ years were (4.63%). Total of 1112 drugs were prescribed, giving an average of 7.36 drugs per person (range 1-9). With regard to WHO indicator, a total 569(51.25%) drugs were prescribed by generic name and 767(68.97%) of drugs were prescribed in accordance to WHO Essential Drug List. Out of 151 prescriptions 330 PIMs were identified from Beer’s list and majority of drugs were belonging to the class of anti-microbial (13.21%) followed by vitamins and dietary supplements (11.24%), drug acting on GI system (9.5%), Anti-hypertensive (8.27%). Conclusion: Study has shown the pattern of drug uses in elderly, PIMs, Polypharmacy were high among the elderly. Prescriber needs to be educated about the beer’s criteria and encourage for more rational prescription and to form guidelines for safe and effective uses of medicine in elderly patients.

Keywords: Drug Utilization pattern, Elderly patients, Beer’s criteria, PIMs, Polypharmacy.