Prevalence and Predictors of Inappropriate Medications Prescribing Among Elderly Outpatients at a University Hospital in Northwestern Ethiopia: A Retrospective Cross-Sectional Study

Abstract

A cross-sectional study was conducted at Gondar university referral hospital from 10^th of February to 5^th of March 2012 using retrospective data on the diseases and medications from medical records of 392 elderly outpatients aged 60 years or older. Data analysis involved use of World Health Organization (WHO) prescribing indicators, Updated 2002 Beer’s criteria and DRUG-REAX^® system software package of MICROMEDEX (R) Healthcare Series to assess the prescribing pattern, identify potentially inappropriate medications and potential drug-drug interactions, respectively. Statistical analyses done included binary logistic regression using SPSS version 16. The results indicated that anti-infectives were the most commonly prescribed medications. Average number of medications per patient was 1.63 and antibiotics were prescribed during 35.5% of patient encounters. Among the 255 patients aged 65 years or older, 25 (9.8%) were prescribed potentially inappropriate medications based on 2002 Beers criteria. Among the 189 patients prescribed with two or more medications, 47 (24.9%) encountered at least one potential drug-drug interaction. Number of medications and diagnosis with hypertension were significant predictors of potentially inappropriate medication and presence of drug interactions. Based on WHO's prescribing indicators, the pattern of prescribing was generally acceptable except for high prescription of antibiotics. However, considerable proportion of cases of prescribing of potentially inappropriate medications and those with potential drug-drug interactions were documented in this study.

Keywords: Beers list/criteria, drug-drug interaction, elderly, prescribing pattern, Ethiopia