engleski

Prescribing of potentially inappropriate drugs in the elderly

Background and objective: Drug prescribing is the most common medical intervention in the elderly. However, elderly patients are more sensitive to the drug’s effects due to pharmacokinetic and pharmacodynamic changes associated with aging. Chronic diseases and co-morbidities often require the use of a large number of medications. Therefore, when prescribing drugs for the elderly, the choice of suitable drugs, dosage and duration of treatment should be carefully considered as well as clinically significant drug interactions. Inappropriate prescribing is often associated with an increased risk of adverse drug reactions, increased morbidity and mortality, and health care costs. The aim of this study was to determine the incidence of potentially inappropriate medications (PIM) prescriptions in the elderly (C65 years) using the original protocol developed by Mimica Matanovic and Vlahovic-Palcevski.Setting and method: We enrolled 240 patients hospitalized in Clinic of Internal Medicine. Data about patients’ medications was collected during patient interview taken by the pharmacists on hospital admission. Pharmacotherapy was analysed using the original protocol developed by Mimica Matanovic and Vlahovic-Palcevski in order to detect PIMs. Main outcome measures: number and type of potentially inappropriate medications, potential clinically significant interactions. Results: The average age of patients was 74 years (range 65–92), and the average number of drugs per respondent was 6.7 (range 1–15). A total of 109 patients (45.4%) were taking at least one PIM. The most common PIM were long-acting benzodiazepines, central antihypertensive moxonidine and non- steroidal anti-inflammatory drugs (NSAIDs) in patients with hypertension. In the study population, 110 patients (45.8%) have taken at least one combination of drugs that could result in a clinically significant interaction. The most common combinations included application of NSAIDs and antihypertensive drugs or diuretics, concomitant use of multiple medications with effects on the central nervous system and drug combinations that can cause hyperkalemia. Conclusion: This study revealed the high prevalence of inappropriate prescribing. Clinical application of this protocol could be an effective method for improving and optimizing drug prescription with the aim to reduce the number of side effects and the morbidity and mortality associated with the drug use in the elderly.

potentially inappropriate drugs, elderly

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