Profile of the prescription of potentially inappropriate medications in hospitalized elderly patients

Abstract

Objective: To characterize the profile of the prescription of potentially inappropriate medications for the elderly (PIME) in hospitalized older adults, considering the aspects of necessity and safety of pharmacotherapy. Methods: A cross-sectional, retrospective, and descriptive study conducted in a high-complexity teaching hospital, assessing the profile of PIME usage in hospitalized patients aged 60 years or older, based on the 2023 Beers Criteria. Data were obtained from reports of the University Hospital Management Application (AGHUx) and compiled in a Microsoft Excel spreadsheet for interpretation and statistical analysis. To evaluate safety aspects, five classification categories contained in the Beers Criteria were used. Results: This study demonstrated that throughout the study period, 96,6% of patients used at least one PIME, and 37,3% of standardized medications appeared in at least one of the categories 2, 3, 4, or 5 of the 2023 Beers Criteria update. The most prevalent classes among the male population aged 60 to 70 years were proton pump inhibitors (PPI) (21,3%), diuretics (17,0%), and antipsychotics (8,6%), while among females aged 60 to 70 years, the use of opioids (6,3%) and benzodiazepines (6,7%) was notable. Among all prescriptions analyzed in the study, 29,8% included at least one PIME. The use of PIME is associated with the presence of polypharmacy (χ2 = 75,338; p<0,01, d= 0,52). Conclusion: This study highlighted a high prevalence of PIME in hospitalized elderly individuals at the study institution, with 96,6% of patients using at least one of these medications during hospitalization. Given the risks associated with PIME use, the need for new studies to quantify the impact of these medications on the health of hospitalized elderly people, as well as the promotion of educational actions regarding PIMs to improve monitoring the safety of therapy for elderly individuals.