Inappropriate medications using the Beers criteria in Brazilian hospitalized elderly patients.

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.