Applying Beers Criteria for Elderly Patients to Assess Rational Drug Use at a University Hospital in Northern Cyprus

J Pharm Bioallied Sci. 2019 Apr-Jun;11(2):133-141. doi: 10.4103/jpbs.JPBS_208_18.

Abstract

Background: Several regulations for potentially inappropriate medications (PIMs) have been published specifically for elderly patients to rationalize drug use in such vulnerable communities.

Objectives: To determine the proportion and characteristics of PIMs in patients receiving one or more drugs according to Beers Criteria 2015.

Materials and methods: A cross-sectional prospective analysis of 451 inpatients admitted between September 25 and October 25, 2016, was conducted in Near East University Hospital, Northern Cyprus. Data were extracted from the patient medical records using special forms.

Results: A total of 119 elderly patients were identified (26.4%) and evaluated, of which 107 were eligible and 12 were excluded. Of the 1039 prescribed medicines, 16.9% were PIMs during hospitalization, whereas 12% were at discharge. The most prevalent PIM group during hospitalization was identified as the "medications to be avoided in older adults" (48.8%), whereas it also formed 52% of medications prescribed at discharge. PIMs of the class "drugs used with caution" formed 19.4% of prescribed medicine during hospitalization and 18.4% on discharge. The prevalence of polypharmacy was 79.4%, mainly identified as unpreventable polypharmacy of elders.

Conclusion: A significantly higher prevalence of PIMs was observed in hospitalized patients than those discharged, with high prevalence of polypharmacy. These results necessitate a nationwide assessment, and responsible bodies who adopt strategies should act to reduce or overcome the aforementioned high prevalence in Northern Cyprus.

Keywords: Beers Criteria; elderly tool; geriatric; pharmacy practice; potentially inappropriate medications; rational drug use.