Prevalence and Risk Factors of Potentially Inappropriate Medication (PIM) Prescribing in Geriatrics: A Study Based on Beers Criteria 2019 at Hospital Kemaman Outpatient Pharmacy

Abstract

Introduction:
Potentially inappropriate medications (PIM) are drugs in which the risks of use in older adults outweigh the clinical benefits, particularly when safer and equally or more effective alternatives are available. Older adults especially geriatrics are more likely to experience multimorbidity and polypharmacy, increasing their risk of exposure to PIM. This study aimed to determine the prevalence of PIM prescribing among geriatric patients attending the outpatient pharmacy of Hospital Kemaman and to identify factors associated with PIM use based on the 2019 Beers Criteria.
Methods:
This cross-sectional study was conducted from January 2023 to August 2023. Patients aged 65 years and above who were under specialist clinic follow-up and had at least one prescribed medication at the outpatient pharmacy were recruited. Prescriptions of the patients meeting the inclusion criteria were reviewed for PIM. Descriptive statistics were employed to present the demographic and clinical data. Associated factors were assessed using multiple logistic regression with a P-value <0.05 considered statistically significant.
Results:
A total of 381 patients were included, of which 62.7% (n= 239) were male, and the majority (n= 308, 80.8%) were of Malay ethnicity. This study identified 181 (47.5%) instances of PIM, with the highest prevalence being PIM classified as ‘use with caution in older adults’ (33.9%). There was a significant association between polypharmacy and the presence of PIM. The most commonly prescribed PIM was frusemide (22.2%).
Conclusion:
This study revealed a high prevalence of PIM prescribing among geriatric patients at the outpatient pharmacy of Hospital Kemaman, which was significantly associated with polypharmacy. Greater emphasis should be given on improving the healthcare professionals' awareness on PIM prescribing in order to enhance medication safety among geriatric patients in outpatient settings.