Drug Prescription Patterns in Old Age:A Prospective Study of Prescribed Drugs at Hospital Discharge.

BACKGROUND

Irrational prescription of medicine is a common problem in medical practice. This is more so in the immediate post admission period. The aim of this study was to characterize drug prescriptions patterns for elderly patients at hospital discharge and to detect areas of irrational and inappropriate prescription.

STUDY DESIGN

This was a longitudinal prospective study of drugs prescribed at hospital discharge for patients aged 65years and above. The World Health Organization (WHO) drug use indicators were used to characterize the drug prescription. The drugs prescribed were classified using the Anatomical Therapeutic Chemical (ATC) classification systemwhile potentially inappropriate medications were determined using the Beers criteria by the American Geriatric Society.

RESULTS

A total of 1,679 drugs were prescribed in 269 patient encounters surveyed. The average number of drugs prescribed per encounter was 6.2 ± 2.1. Vitamins and antihypertensive agents accounted for 23.2% (n=390/1,679) and 15.2% (n=256/1,679) of prescribed drugs respectively. At least one potentially inappropriate medicationwas prescribed for 48 patients giving a rate of 17.8%(48/269) and the non-steroidal anti-inflammatory drugs (NSAIDs)were the most frequently prescribed potentially inappropriate medications.

CONCLUSION

The average number of medicines per patient encounter which is a measure of the degree of polypharmacywas high in the study and suggests irrational drug prescription. Thefrequent prescription of potentially inappropriate medicines noted in the study further highlights the need forfurther training of the prescriberson geriatric drug prescriptions.