Potentially Inappropriate Medications in Indian Geriatric Patients Visiting Out-patient Departments of Tertiary Care Teaching Hospital

Aim: To investigate the prevalence of potentially inappropriate medications (PIMs) identified by the American Geriatrics Society Beers 2019 criteria in geriatric patients in India. Materials and Methods: This cross-sectional study was conducted between October 2018 and October 2019 in the tertiary care teaching hospital of the Gujarat state, India. Patients of either sex attending outpatient departments of age 65 years and above were included. Data including age, gender, department, relevant laboratory investigations, prescribed drugs, dosages, and duration was recorded in the Case Record Form. PIMs identified as per 2019 Beers criteria and analyzed. The association between age, gender, polypharmacy and encounter of PIMs was analyzed. Results: A total of 306 patients were analyzed. Mean age of patients was 69.43 (standard deviation = 5.47) years and 185 (60.46%) were male. At least one PIM was prescribed in 46% (140) patients. Two or more PIMs were prescribed in 18.6% of patients. The most frequent PIMs independent of diagnosis and condition (Criteria 1) were first-generation antihistaminics 25.7%, skeletal muscle relaxants 21% and sulfonylureas (glimepiride) 17.4%. The most common drugs to be used with caution (Criterion 3) included tramadol 50.75%, diuretics 25.4%, and antipsychotics 13.5%. Patients who were on polypharmacy were at significantly high (P < 0.001) risk of PIM use with an adjusted odds ratio 4.864 (95% confidence interval: 2.95–8.03). Conclusion: Our study showed a high prevalence of PIMs use in Indian geriatric patients. There was an association between inappropriate medication use and polypharmacy.