Inappropriate medications using the Beers criteria in Brazilian hospitalized elderly patients

Juliana Locatelli, Andreia Ramos Lira, Luciana K L A Torraga, Angela Tavares Paes
Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists 2010, 25 (1): 36-40

OBJECTIVE: To study the prevalence and to identify risk factors of using potentially inappropriate medication (PIM) in hospitalized elderly patients.

DESIGN: A cross-sectional study was conducted. For identification of PIM, modified 2003 Beers criteria were used.

SETTING: The private Hospital Israelita Albert Einstein admission wards.

PATIENTS, PARTICIPANTS: 250 elderly patients (>or = 60 years of age) with a length of stay > or = 48 hours up to 30 days.


MAIN OUTCOME MEASURE: The main outcome measure was to study the prevalence and to identify risk factors of using PIM in hospitalized elderly patients.

RESULTS: 156 (62%) patients used at least one PIM independent of diagnosis or condition, and 28% currently used the PIMs at home. The most frequent PIM, independent of diagnosis or condition, was scopolamine (27.2%), followed by clonazepam (17.9%) and amiodarone (16.4%). The prescription of PIM was related to number of drugs (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.05-1.23, P = 0.001), female gender (OR 2.36, 95% CI 1.34-4.14, P = 0.003), nongeriatrician prescribers (OR 5.54, 95% CI 1.62-18.89, P = 0.006), heart disease (OR 2.17, 95% CI 1.22-3.85, P = 0.008), and depression (OR 3.34, 95% CI 1.33-8.31, P = 0.010).

CONCLUSION: The present study has shown that the use of PIM is usual in hospitalized patients, and the Beers list must be used as a guide of good practices rather than being used prohibitively. This study will serve as a base for selection and intervention programs on medical prescription in order to warrant a safe and effective drug therapy for hospitalized elderly patients.

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