Prescription of potentially inappropriate medications in geriatric patients: data from a single dental institution

Abstract

The Beers criteria and the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) are consensus-driven lists of potentially inappropriate medications (PIMs) in geriatric patients. The primary objective was to determine the frequency of PIMs prescribed to geriatric patients at Tufts University School of Dental Medicine. The secondary aim was to determine the American Society of Anesthesiologists (ASA) status of these patients and suggest that Beers/STOPP guidelines should be implied with consideration to the patient's ASA status. Beers/STOPP criteria were studied and PIMs thus identified. A retrospective electronic chart review of patients at TUSDM aged 65 and older was performed for calendar years 2013, 2014, and 2015. Search queries were generated for ASA status, along with PIMs prescribed. Out of 15,569 geriatric patients, more than half of patients between 65-74 years were classified as ASA I. Over a 3-year period, 895 (5.75%) and 840 (5.4%) received new prescriptions for opioids or nonsteroidal anti-inflammatory drugs, respectively. New prescriptions for muscle relaxants, benzodiazepines, and tricyclic antidepressants were given to 65 (0.42%), 44 (0.28%), and 38 (0.24%) patients, respectively. PIMs are prescribed at low percentages to geriatric patients. However, prescription of opioids, benzodiazepines, and nonsteroidal anti-inflammatory drugs across undergraduate and postgraduate clinics is not uncommon. The majority of Tufts University School of Dental Medicine geriatric patients fall within the category of ASA I-II. ASA classification must be taken into consideration when PIMs are prescribed to geriatric patients rather than relying solely on chronologic age.