Inappropriate drug use in hospitalized elderly patients of medicine and cardiology departments at a tertiary care hospital of Northeast India

Abstract

BackgroundNational committee on quality assurance, USA convened an expert consensus panel and identified the list of drugs which should be avoided in the elderly people. This resulting list of drugs after 2003 beers criteria were added to the 2006 Health Plan Employer Data and Information Set (HEDIS) to assess the drug prescribing in elderly people. MethodsThe objective of this study was to determine the prevalence of inappropriate drug use and assess their predictors in the hospitalized elderly patients of tertiary care hospital by using HEDIS 2006 criteria. A 6-month prospective study was conducted in medicine & cardiology inpatient department of tertiary care hospital by reviewing prescriptions of 502 elderly patients. The patients of either sex having age more than 60 year were included in this study. ResultsIt is found that (2.39%) 12 patients received at least 1 inappropriate drug by 2006 HEDIS measure. Out of 12 inappropriate drugs, short acting nifedipine was prescribed to 4 elderly patients followed by dicyclomine to 2 patients and ketorolac to 2 patients each. Increased number (≥11) of concurrent medications use during hospital stay (OR: 0.015, CI: 0.001–0.199, P = 0.001) and prolonged (≥5 days) length of stay (OR: 0.039, CI: 0.005–0.291, P = 0.002) were found as a predictors of inappropriate medication use. ConclusionIn this study, low prevalence (2.39%) of inappropriate drug prescribing was found. Multiple medications and long duration of hospital stay were the risk factors for inappropriate medication use.