Drug Utilization Pattern and Potentially Inappropriate Medications among Elderly Inpatients in a Tertiary Care Hospital in Western Nepal

Abstract

Introduction: Drug utilization research deals with the quality of care focusing on potentially inappropriate medication (PIM), The objectives of the study were to assess the drug utilization pattern (class of drugs used, average number of drugs per prescription per encounter, number of drug prescribed in generic name and antibiotics in prescription) and potentially inappropriate medications and their categories among elderly inpatients. Methods: It was a prospective observational study carried out in the medical department of Western Regional Hospital, one of the tertiary level public referral hospital in Pokhara, Nepal. One hundred and two patients of both sexes, age above 65 years and who were hospitalized in medical department were selected. The patients were followed until their discharge to obtain complete information about the drugs being used. Patient data collection form and Updated 2012 Beers Criteria were used to assess drug utilization patterns and determine PIM respectively. Results: Most of the patients were in the age group of 65-70 (37.25%) followed by 71-75 (27.45%) and 76-80 (18.62%). Out of 102 patients, 53 (51.97%) were male and 49 (48.03 %) were female. Antimicrobials were the most prescribed medicines (16.73%). Average number of drugs per prescription per encounters, number of drug prescribed in generic name and number of antibiotics in prescription were 7.26, 9.6% and 21% respectively. About 57% of medicines were prescribed from the national essential medicine list. Among them, 20 (3.91%) of all drugs had at least one PIM. There were 27 drugs in Beers criteria A, one drug in Beers criteria B, and no drug in Beers criteria C. Conclusion: Antibiotic prescription was found within the optimal values whereas values of other prescribing indicators were out of the optimal values in comparing earlier studies. PIM was observed in prescriptions that suggest irrational practice and the need for interventions.