Identification and acceptance of suggested therapeutic alternatives of potentially inappropriate medications amongst hospitalised geriatric patients in Iran

Abstract

The Beers Criteria (BC) are frequently used to identify potentially inappropriate medications (PIMs) in geriatric patients. There are limited reports from non-Western countries documenting the rate of both PIM identification and acceptance of pharmacist-suggested changes to medications in geriatric patients. This prospective interventional study identified PIMs using the BC in hospitalised geriatric patients in an Iranian hospital, and documented the rate of acceptance of alternative therapies suggested by a clinical pharmacist. All patients aged ≥65 years (n = 240) who were admitted to medical and surgical wards for ≥3 days were included in the study. PIMs were screened for on Day 2 of admission using 2015 BC and therapeutic alternatives were suggested if a PIM was identified. Whether the suggestions were accepted was determined on Day 3. At least one PIM was identified for 80 (33.3%) patients, with 95 PIMs reported overall. The most frequent PIMs recorded were pethidine (44.2%), alprazolam (8.4%) and metoclopramide (7.3%). Of the 95 interventions suggested, 87 (91.5%) were accepted by physicians. The identification of PIMs and provision of alternative treatment options by an experienced clinical pharmacist resulted in a high uptake of recommendations.