Use of potentially inappropriate medication among elderly patients in the hospitals of Western Kazakhstan: a cross-sectional study
Purpose of the research. Elderly patients are at increased risk of life-threatening consequences associated with the use of potentially inappropriate medications (PIM). This research is aimed at studying the practice of prescribing PIM to elderly patients and polypharmacy in hospitals of Western Kazakhstan. Methods: A pharmacoepidemiological cross-sectional study was conducted in 5 (five) hospitals of Western Kazakhstan. The sample consisted of in-patients aged 65+ years. The data were collected from medical records from January 1, 2014 to December 31, 2014. The prescription lists of 894 geriatric patients over the age of 65 were examined. Results: The highest percentage of PIM was prescribed in the Surgery Departments, where 57.4% (95% CI 48.3-66.4) of patients of this age group received metoclopramide and ketoprofen therapy. The second department was the Cardiology Department according to the frequency of the use of PIM, where 47.9 (95% CI 43.5-50.7) % of elderly patients received drugs from the Beers list. The most commonly prescribed medications were spironolactone in a dose of more than 25 mg per day (37.2%), diazepam (10.4%), digoxin in a dose of more than 0.125 mg per day (8.7%). Amiodarone (4.6%), nitrofurantoin (3.2%), metoclopramide (2.9%) were also relatively frequently prescribed. Polypharmacy prevails in the Departments of Neurology (94.9%) and Cardiology (93.8%). Conclusion: A high percentage of the use of PIM from the Beers list was observed among the elderly patients in surgical and cardiological practice. A high prevalence of polypharmacy was observed in the Departments of Neurology and Cardiology that may increase the risk of unfavourable outcomes in patients of this age group.