Analysis of inappropriate medication use and drug interaction in older people visiting tertiary care center of eastern Nepal

Abstract

Background: Medication use in older people has been increasing as the incidence of chronic diseases increases worldwide. Use of more medicines may increase the chance of prescribing potentially inappropriate medications (PIMs) and may increases the risk of potential drug-drug interactions (pDDIs). The objective of this study was to assess PIMs and pDDIs to improve the rational use of medicationsMethods: In this study data from the older people were obtained from patient visiting medicine, OPD, BPKIHS, Dharan. Demographic and medications information were collected. PIM and pDDIs were evaluated from medication data using the Beer’s criteria for potentially inappropriate medication use in older adults, 2015 and lexicomp application respectively.Results: Among 550 patients 50.9% patients were male. Common diagnosis was systemic hypertension 335 (64.5%) followed by type 2 diabetes mellitus 276 (50.18%). The most commonly prescribed drug was metformin (215) followed by amlodipine (205), atorvastatin (176), losartan (158), glimepiride (113) and aspirin (100). One or more fixed drug combination was present in 295 prescriptions. One or more PIM were present in 29 (5.3%) prescriptions. Commonly prescribed PIM was prazosin (11) followed by nitrofurantoin (5). There were total of 753 cases of pDDIs, with 116 (15.40%) cases of risk categories X and D.Conclusions: Our findings demonstrated PIM use were relatively less. However, pDDIs were common in older people suggesting that optimal medication use and further similar studies in larger scale are necessary in this population.