Giri Roshan, Shrestha Rajeev, Rai Aatma, Kandel Gobinda, Gauchan Punam, Thapa Parbati
Pharmaceutical Sciences Program, School of Health and Allied Sciences Pokhara University Pokhara Nepal.
Department of Pharmacy Bharatpur Hospital Bharatpur Nepal.
Aging Med (Milton). 2025 Aug 14;8(4):303-311. doi: 10.1002/agm2.70034. eCollection 2025 Aug.
Potentially Inappropriate Medications (PIMs) and Drug-Drug Interactions (DDIs) among geriatrics are a prominent issue and place a considerable burden on the quality health outcome. This study aimed to assess PIMs and DDIs particularly among geriatric cardiac elderly patients attending the outpatient department of a tertiary care hospital of Nepal.
A prospective cross-sectional study was conducted on geriatrics patients (≥ 65 years) attending the cardiology out-patient department of Bharatpur Central Hospital, Nepal. Beers criteria were used to assess PIM, and Medscape software was employed to assess DDIs. Regression analysis was performed to identify the predictors of PIM and DDIs experienced by patients.
A total of 140 geriatric patients were enrolled in the study. A total of 683 drugs were prescribed to them, with an average of 4.59 medications per patient. 23.6% and 65% of patients were found to be prescribed PIMs and encountered DDIs, respectively. Proton Pump Inhibitors (PPI) (66.67%) were the most prescribed PIMs and involved in identified DDIs. The removal of PIMs was calculated to reduce 11.72% of the cost of patients prescribed PIMs and 19.88% of identified DDIs. The number of medications prescribed was found to be a significant predictor for PIM (Odd Ratio: 1.352) and DDIs (Odd Ratio: 2.217) encountered.
This study highlights the concerning prevalence of potentially inappropriate medication and drug-drug interactions among ambulatory cardiac elderly patients. Integration of regular medication audits and evidence-based prescribing practices is essential to optimize pharmacological management and enhance patient safety.
老年患者中潜在不适当用药（PIMs）和药物相互作用（DDIs）是一个突出问题，给优质健康结局带来相当大负担。本研究旨在评估特别是在尼泊尔一家三级医院门诊部就诊的老年心脏病患者中的PIMs和DDIs。
对尼泊尔巴拉特普尔中央医院心脏病门诊部的老年患者（≥65岁）进行了一项前瞻性横断面研究。采用Beers标准评估PIM，使用Medscape软件评估DDIs。进行回归分析以确定患者经历的PIM和DDIs的预测因素。
共有140名老年患者纳入研究。共为他们开具了683种药物，每位患者平均用药4.59种。分别有23.6%和65%的患者被开具了PIMs并遭遇了DDIs。质子泵抑制剂（PPI）（66.67%）是最常开具的PIMs，且涉及已识别的DDIs。经计算，去除PIMs可使开具PIMs患者的费用降低11.72%，使已识别的DDIs减少19.88%。发现开具的药物数量是患者遭遇PIM（比值比：1.352）和DDIs（比值比：2.217）的显著预测因素。
本研究突出了门诊心脏病老年患者中潜在不适当用药和药物相互作用令人担忧的患病率。整合定期药物审核和循证处方实践对于优化药物管理和提高患者安全至关重要。
