Assessment of Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward According to the 2019 Beers Criteria

Author(s): Cátia Pereira, Ana Guiomar, Alexandra Cunha, Catarina Alves Cunha, José Pedro Barbosa, Jorge Fortuna

Drug prescribing in older adults presents a serious challenge in medical clinical practice as this group of patients is particularly susceptible to drug-related side effects. American Geriatrics Society Beers Criteria serve as guidelines for clinicians to prevent potentially inappropriate prescribing in adults aged 65 years and older. Along with other tools and clinical judgment, these criteria can be used as a prescribing quality indicator. The purpose of this study was to determine the prevalence of potentially inappropriate prescription and the most common potentially inappropriate medications prescribed among older patients at admission in an internal medicine ward, as well as its rate of discontinuation by clinicians by the time of discharge. This assessment was made in light of the American Geriatrics Society 2019 Updated AGS Beers Criteria. Data from three internal medicine wards of the University of Coimbra Hospital Center were analyzed during July 2019, resulting in a total of 153 selected patients. The mean age was 85 (SD 7.32) years and most of the patients were female (58%). On admission, 75% of patients had at least one potentially inappropriate drug prescribed. At discharge, the drug was discontinued in 21% of these patients. One potentially inappropriate drug was introduced in 16% of patients. More than ever, we must acknowledge deprescribing as an important component of a good prescribing continuum. Our results highlight clinicians’ poor recognition of potentially harmful drugs in the elderly and the urge to define a strategy that allows appropriate therapeutic adjustments in this age group.

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