Skip to main content
Log in

Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman

  • ORIGINAL ARTICLE
  • Published:
Journal of Cross-Cultural Gerontology Aims and scope Submit manuscript

Abstract

Drug prescribing to the elderly increases the risk of potential adverse drug reactions as well as potentially inappropriate medications. The goal of this study was to describe drug prescribing patterns in elderly patients and to measure the prevalence of potentially inappropriate medications using updated Beers’ criteria and the STOPP criteria. This was a retrospective cross-sectional study for all patients aged ≥65 years who attended regularly a primary care clinic at Sultan Qaboos University Hospital in Oman. Data of 377 patients were analyzed using the software Statistical Package for Social Sciences version 23.0 (SPSS™, Chicago, IL, USA). Using Beers criteria, the prevalence of potentially inappropriate medications was 12.7% as 48 patients had at least one potentially inappropriate medication. Beers criteria revealed a statistical association between the occurrence of potentially inappropriate medications with polypharmacy (p < 0.001), with female gender (p = 0.002) and with asthma as a comorbidity (p = 0.020). STOPP criteria showed that the prevalence of potentially inappropriate medications was 17.2% as 65 patients had at least one potentially inappropriate medication. STOPP criteria revealed a statistical association between the occurrence of potentially inappropriate medications and osteoarthritis as a comorbidity (p = 0.032). The study revealed moderate prevalence of potentially inappropriate medications prescribing in elderly patients which was mainly associated with polypharmacy and female gender. Safe prescribing practices in the elderly requires increasing the awareness of healthcare providers and efficiently reporting drug-related problems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Agostini, J. V. (2007). Measuring drug burden: A step forward. Archives of Internal Medicine, 167, 753–754.

    Article  Google Scholar 

  • American Geriatrics Society. (2015). Updated beers criteria for potentially inappropriate medication use in older adults. By the American Geriatrics Society 2015 beers criteria update expert panel. Journal of the American Geriatrics Society, 63(11), 2227–2246.

    Article  Google Scholar 

  • Arellano, C., Saldivia, G., Córdova, P., Fernández, P., Morales, F., López, M., & Villa, L. (2016). Using two tools to identify Potentially Inappropriate Medications (PIM) in elderly patients in Southern Chile. Archives of Gerontology and Geriatrics, 67, 139–144.

    Article  Google Scholar 

  • Arnett III, R. H., Blank, L. A., Brown, A. P., et al. (1990). National health expenditures 1988. Office of National Cost Estimates. Health Care Financing Review, 11, 1–41.

    Google Scholar 

  • Ay, P., Akici, A., & Harmanc, H. (2005). Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, Turkey. International Journal of Clinical Pharmacology and Therapeutics, 43(4), 195–202.

    Article  Google Scholar 

  • Cahir, C., Fahey, T., Teeling, M., Teljeur, C., Feely, J., & Bennett, K. (2010). Potentially inappropriate prescribing and cost outcomes for older people: A national population study. British Journal of Clinical Pharmacology, 69(5), 543–552.

    Article  Google Scholar 

  • Carey, I. M., De Wilde, S., Harris, T., Victor, C., Richards, N., Hilton, S. R., & Cook, D. G. (2008). What factors predict potentially inappropriate primary care prescribing in older people? Drugs & Aging, 25, 639–706.

    Article  Google Scholar 

  • Christchilles, E. A., Foley, D. J., Wallace, R. B., et al. (1992). Use of medications by persons 65 and over: Data from the established populations for epidemiologic studies of the elderly. Journal of Gerontology, 47, 137–144.

    Article  Google Scholar 

  • Fadare, J. O., Agboola, S. M., Opeke, O. A., & Alabi, R. A. (2013). Prescription pattern and prevalence of potentially inappropriate medications among elderly patients in a Nigerian rural tertiary hospital. Therapeutics and Clinical Risk Management, 9, 115–120.

    Article  Google Scholar 

  • Gallagher, P., Barry, P., & O'Mahony, D. (2007). Inappropriate prescribing in the elderly. Journal of Clinical Pharmacy and Therapeutics, 32, 113–121.

    Article  Google Scholar 

  • Gallagher, P., Ryan, C., Byrne, S., Kennedy, J., & O’Mahony, D. (2008). STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment). Consensus validation. International Journal of Clinical Pharmacology and Therapeutics, 46(2), 72–83.

    Article  Google Scholar 

  • Goldberg, R. M., Mabee, J., Chan, L., & Wong, S. (1996). Drug-drug and drug-disease interactions in the emergency department: Analysis of a high-risk population. American Journal of Emergency Medicine, 14, 447–450.

    Article  Google Scholar 

  • Guaraldo, L., Cano, F. G., Damasceno, G. S., & Rozenfeld, S. (2011). Inappropriate medication use among the elderly: A systematic review of administrative databases. BMC Geriatrics, 11, 79.

    Article  Google Scholar 

  • Juurlink, D. N., Mamdani, M., Kopp, A., Laupacis, A., & Redelmeier, D. A. (2003). Drug–drug interactions among elderly patients hospitalized for drug toxicity. JAMA, 289(13), 1652–1658.

    Article  Google Scholar 

  • Liu, G. G., & Christensen, D. B. (2002). The continuing challenge of inappropriate prescribing in the elderly: An update of the evidence. Journal of the American Pharmacists Association, 42(6), 847–857.

    Google Scholar 

  • Narvekar, R. S., Bhandare, N. N., Gouveia, J. J., & Bhandare, P. N. (2017). Utilization pattern of potentially inappropriate medications in geriatric patients in a tertiary care hospital: A retrospective observational study. Journal of Clinical and Diagnostic Research, 11(4), FC04–FC08.

    Google Scholar 

  • O’Mahony, D., Gallagher, P., Ryan, C., Byrne, S., Hamilton, H., Barry, P., O’Connor, M., & Kennedy, J. (2010). STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age. European Geriatric Medicine, 1(1), 45–51.

    Article  Google Scholar 

  • O'Neill, C., Hughes, C. M., Jamison, J., & Schweizer, A. (2003). Cost of pharmacological care of the elderly: Implications for healthcare resources. Drugs & Aging, 20(4), 253–261.

    Article  Google Scholar 

  • Perri 3rd, M., Menon, A. M., Deshpande, A. D., Shinde, S. B., Jiang, R., Cooper, J. W., Cook, C. L., Griffin, S. C., & Lorys, R. A. (2005). Adverse outcomes associated with inappropriate drug use in nursing homes. The Annals of Pharmacotherapy, 39(3), 405–411.

    Article  Google Scholar 

  • Rajska-Neumann, A., & Wieczorowska-Tobis, K. (2007). Polypharmacy and potential inappropriateness of pharmaco-logical treatment among community-dwelling elderly patients. Archives of Gerontology and Geriatrics, 44(Suppl 1), 303–309.

    Article  Google Scholar 

  • Ryan, C., O'Mahony, D., Kennedy, J., Weedle, P., & Byrne, S. (2009). Potentially inappropriate prescribing in an Irish elderly population in primary care. British Journal of Clinical Pharmacology, 68(6), 936–947.

    Article  Google Scholar 

  • Spinewine, A., Schmader, K. E., Barber, N., Hughes, C., Lapane, K. L., Swine, C., & Hanlon, J. T. (2007). Appropriate prescribing in elderly people: How well can it be measured and optimised? Lancet, 370(9582), 173–184.

    Article  Google Scholar 

  • Steinman, M. A., Landefeld, C. S., Rosenthal, G. E., Berthenthal, D., Sen, S., & Kaboli, P. J. (2006). Polypharmacy and prescribing quality in older people. Journal of the American Geriatrics Society, 54(10), 1516–1523.

    Article  Google Scholar 

  • Ubeda, A., Ferrándiz, L., Maicas, N., Gomez, C., Bonet, M., & Peris, J. E. (2012). Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria. Pharmacy Practice (Granada), 10(2), 83–91.

    Article  Google Scholar 

  • World Health Organization, Geneva (1993). How to investigate drug use in health facilities: selected drug use indicators. EDM Research, Series No. 007.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Khalid Al Balushi.

Ethics declarations

Conflict of Interest

None.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Al-Busaidi, S., Al-Kharusi, A., Al-Hinai, M. et al. Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman. J Cross Cult Gerontol 35, 209–216 (2020). https://doi.org/10.1007/s10823-019-09393-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10823-019-09393-5

Keywords

Navigation