Abstract

Background & Objectives:Rational prescribing can prevent medication errors and the associated harm, especially in old age patients, as they are being frequently prescribed with drugs for various ailments. Moreover, polypharmacy is a common practice in them. Therefore, a significant threat of potential drug interactions and adverse effects exist. Current study focuses on assessment of Potentially Inappropriate Medication (PIM) in medication prescribed to old age patients.Methods:It was a forty days, descriptive and observational study conducted from August 15th 2017 to September 25th 2017 in which prescriptions given to elderly patients were reimbursed for collecting various sets of information. In order to assess PIMs (in Pakistani Set-up), STOPP/START addition 2008 (including examples of misprescribing, overprescribing and under prescribing) and the PRISCUS list (misprescribing and overprescribing) was used. Statistical analysis of results was performed using SPSS version 20.Results:One hundred forty six cases of PIMs (including incorrect prescribing, overprescribing and under prescribing) were detected. It included incorrect prescriptions 104, under prescription 28 and over prescriptions 14. NSAIDS accounted for most incorrect prescriptions followed by benzodiazepines. Mostly NSAIDS were used for myalgia, backache and rheumatoid disorders.Conclusion:Current findings highlighted Potentially Inappropriate Prescribing (PIP), particularly of NSAIDs and under prescribing of statins in cardiovascular diseases. Study findings suggest introducing pertinent interventions at the stages involved in prescribing, prescription review and its follow up to reduce the PIP and PIMs.

Highlights

  • Prescribing quality is an important cognitive factor for determining the wellbeing of elderly population while increased demand of an effective prescribing is a challenge for primary health care practitioners.[1]

  • Inappropriate Medication (PIM) highlights Potentially Inappropriate Prescribing (PIP), Potential Prescribing Omissions (PPO),[7] potentially harmful drug-drug/drug-disease interactions i.e. using Non-Steroidal AntiInflammatory Drugs (NSAIDs) in patients with hypertension,β blocking agents in diabetic patients,[5,8] Poly pharmacy, morbidity, contraindications based on patients genetic profile and those with age related contraindications.[9]

  • This study explores the prevalence rates of Potential Inappropriate Prescribing (PIP) and Potential Prescribing Omissions (PPO) at ambulatory health care setting

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Summary

Introduction

Prescribing quality is an important cognitive factor for determining the wellbeing of elderly population while increased demand of an effective prescribing is a challenge for primary health care practitioners.[1]. A Potentially Inappropriate Medication (PIM) list is a useful tool for elderly in preventing adverse drug events occurring at prescription stage. Current study focuses on assessment of Potentially Inappropriate Medication (PIM) in medication prescribed to old age patients. Results: One hundred forty six cases of PIMs (including incorrect prescribing, overprescribing and under prescribing) were detected. Conclusion: Current findings highlighted Potentially Inappropriate Prescribing (PIP), of NSAIDs and under prescribing of statins in cardiovascular diseases. Study findings suggest introducing pertinent interventions at the stages involved in prescribing, prescription review and its follow up to reduce the PIP and PIMs

Methods
Results
Conclusion
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