Association between Potentially Inappropriate Prescription (PIP) and Health Outcome Among Geriatric Home Residents

Abstract

Background: Appropriate prescribing of medications in elderly especially with advancing age is a major clinical and economic issue. Therefore, health care and appropriate use of medications with advancing age is one of the major challenges facing health care systems. Potentially inappropriate prescriptions (PIP) are defined by the presence of a risk of prescribed drugs that overweighs their benefit. Especially, when there are safer alternatives and include misuse of medications, prescription of drugs with significant drug–drug or drug– disease interactions and the negligence of beneficial medications. Aim of the Study: To assess the association between potentially inappropriate prescription and health outcome among a sample of Egyptian elderly patients in geriatric homes in Cairo. Methods: A cross-sectional study. A random sample of 120 geriatric home residents in Cairo. Demographic data were collected and comprehensive geriatric assessment was done for each participant including history taking, clinical examination, psychological, mental, functional, risk of falls and nutritional assessment. Assessment of potentially inappropriate prescription using STOPP criteria. Results: The present study showed that among the 120 participants; the prevalence of PIP using STOPP criteria was 27(22.5%) of them were taking one or more PIP, 24 (20%) were taking one PIP and 3 (2.5%) were taking 2 PIP, 12 (44.4%) of the studied participants having visual impairment were using PIP regarding STOPP criteria; 7 (25.9%) of the studied participants having hearing impairment were using PIP as detected by STOPP criteria, so there was significant relation between PIP and patients who had visual and hearing impairments, there was a significant relation between PIP among the studied group using STOPP criteria regarding functional assessment (Instrumental activity of daily living (IADL) with p-value equal (0.031), and there was no significant relation with cognitive, psychological, risk of falls and nutritional assessment and there was no significant relation with other health outcome. Conclusion: Potentially inappropriate prescription using STOPP criteria was found to be statistically significant with hearing, visual impairment and regarding functional assessment (IADL) only. No significant association with other health outcome.