Inappropriate medications using the Beers criteria in Brazilian hospitalized elderly patients

Consult Pharm. 2010 Jan;25(1):36-40. doi: 10.4140/TCP.n.2010.36.

Abstract

Objective: To study the prevalence and to identify risk factors of using potentially inappropriate medication (PIM) in hospitalized elderly patients.

Design: A cross-sectional study was conducted. For identification of PIM, modified 2003 Beers criteria were used.

Setting: The private Hospital Israelita Albert Einstein admission wards.

Patients, participants: 250 elderly patients (>or = 60 years of age) with a length of stay > or = 48 hours up to 30 days.

Interventions: None.

Main outcome measure: The main outcome measure was to study the prevalence and to identify risk factors of using PIM in hospitalized elderly patients.

Results: 156 (62%) patients used at least one PIM independent of diagnosis or condition, and 28% currently used the PIMs at home. The most frequent PIM, independent of diagnosis or condition, was scopolamine (27.2%), followed by clonazepam (17.9%) and amiodarone (16.4%). The prescription of PIM was related to number of drugs (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.05-1.23, P = 0.001), female gender (OR 2.36, 95% CI 1.34-4.14, P = 0.003), nongeriatrician prescribers (OR 5.54, 95% CI 1.62-18.89, P = 0.006), heart disease (OR 2.17, 95% CI 1.22-3.85, P = 0.008), and depression (OR 3.34, 95% CI 1.33-8.31, P = 0.010).

Conclusion: The present study has shown that the use of PIM is usual in hospitalized patients, and the Beers list must be used as a guide of good practices rather than being used prohibitively. This study will serve as a base for selection and intervention programs on medical prescription in order to warrant a safe and effective drug therapy for hospitalized elderly patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brazil
  • Cross-Sectional Studies
  • Female
  • Hospitalization
  • Hospitals, Private / statistics & numerical data
  • Humans
  • Male
  • Medication Errors / statistics & numerical data*
  • Middle Aged
  • Practice Patterns, Physicians' / standards*
  • Prescription Drugs / administration & dosage
  • Prescription Drugs / adverse effects
  • Prescription Drugs / therapeutic use*
  • Prevalence
  • Risk Factors
  • Sex Factors

Substances

  • Prescription Drugs