Malekzadeh Mahan, Khadivi Yousef, Sohrevardi Seyed Mojtaba, Afzal Golnaz
Student Research Committee, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Geriatr. 2025 Feb 27;25(1):135. doi: 10.1186/s12877-025-05780-5.
As the population ages, the prevalence of chronic diseases increases, leading to greater reliance on multiple medications that are conducted to increase the risk of adverse drug reactions (ADR) that may cause higher morbidity and mortality rates. This study aims to evaluate medication prescribing patterns in the older adults and assess compliance with the World Health Organization (WHO) guidelines and Beers Criteria.
A cross-sectional study was conducted over six months in 2022, collecting prescriptions for patients aged 65 and above from a 24-hour community pharmacy in Iran. The prescriptions were analyzed according to the WHO prescribing guidelines, including the mean number of prescribed drugs, the number of injectable drugs and antibiotics per prescription, and also the prescription of drugs with generic names and from the list of Essential Drug List (EDL). In addition, the prescriptions were assessed according to the Beers Criteria for the frequency of prescription of potentially inappropriate medications (PIMs). Also, polypharmacy, which is defined as the prescription of more than five drugs per prescription, has been investigated based on the number of drugs prescribed per prescription.
1,053 older patient prescriptions were assessed, whose average age was 72.3 ± 6.7 years, with 36.2% of prescriptions involving polypharmacy (five or more drugs). The most frequent medical discipline of prescribers was general practice (30.3%). The average number of drugs per prescription was 4.1 ± 2.1, which exceeded the WHO recommendation. Additionally, 47.3% of prescriptions contained at least one PIM according to the Beers Criteria, with non-steroidal anti-inflammatory drugs (NSAIDs) being the most common (17.9%). The relative frequency of injectable drugs and antibiotics used per prescription was 20.8 and 18.9%, respectively, while 7.6% of prescriptions did not use generic names.
The study highlights concern about levels of polypharmacy and PIM use in older patients. While the low rate of antibiotic prescribing and relatively high use of generic drugs indicate some positive adherence to WHO guidelines, the frequent prescription of PIMs and the high average number of drugs per prescription point to substantial room for improvement.
随着人口老龄化，慢性病患病率上升，导致对多种药物的依赖增加，这会增加药物不良反应（ADR）的风险，进而可能导致更高的发病率和死亡率。本研究旨在评估老年人的用药处方模式，并评估其是否符合世界卫生组织（WHO）指南和《Beers标准》。
2022年进行了一项为期六个月的横断面研究，从伊朗一家24小时营业的社区药房收集65岁及以上患者的处方。根据WHO的处方指南对处方进行分析，包括处方药物的平均数量、每张处方中注射用药物和抗生素的数量，以及使用通用名的药物和基本药物清单（EDL）中的药物处方情况。此外，根据《Beers标准》评估处方中潜在不适当药物（PIM）的处方频率。此外，还根据每张处方开具的药物数量对多药联用（定义为每张处方开具五种以上药物）进行了调查。
共评估了1053份老年患者处方，患者平均年龄为72.3±6.7岁，36.2%的处方涉及多药联用（五种或更多药物）。开处方者最常涉及的医学专业是全科医学（30.3%）。每张处方的药物平均数量为4.1±2.1，超过了WHO的建议。此外，根据《Beers标准》，47.3%的处方至少含有一种PIM，其中非甾体抗炎药（NSAIDs）最为常见（17.9%）。每张处方使用注射用药物和抗生素的相对频率分别为20.8%和18.9%，而7.6%的处方未使用通用名。
该研究凸显了对老年患者多药联用和PIM使用水平的担忧。虽然抗生素处方率较低且通用药物使用率相对较高表明在一定程度上符合WHO指南，但PIM的频繁处方和每张处方药物的高平均数量表明仍有很大改进空间。
