Evaluating Safety Profile of Pharmacotherapy Among Geriatric Patients in a Tertiary Care Hospital

Geriatric patients are particularly vulnerable to medication-related problems because of polypharmacy, multiple comorbidities, and age-related changes in drug handling. This study aimed to evaluate the rationality and safety profile of pharmacotherapy among hospitalized geriatric patients, with assessment of medication administration practices, potentially inappropriate medications (PIMs), drug-drug interactions (DDIs), and adverse drug reactions (ADRs). A prospective cross-sectional observational study was conducted over six months in a tertiary care hospital in Bangalore, India. A total of 160 patients aged above 65 years who were hospitalized for at least 24 hours and prescribed at least two medications were included. Ethical clearance was obtained from the Institutional Ethics Committee. PIMs were assessed using the 2023 AGS Beers Criteria, medication appropriateness using the Medication Appropriateness Index (MAI), DDIs according to severity, and ADRs using the Naranjo causality scale. Among 160 patients, 186 PIM occurrences were identified, and 70% of patients received at least one PIM. Medication-to-avoid was the most frequent Beers category (46.2%), followed by medications to use with caution (29.6%). A total of 490 DDIs were identified, comprising 103 mild, 332 moderate, and 55 severe interactions. Two ADRs were identified, both classified as probable. MAI assessment showed generally appropriate prescribing, although drug-disease interactions and therapeutic duplication were identified. Regular medication review using Beers Criteria and MAI, together with clinical pharmacist and multidisciplinary involvement, may improve medication safety in hospitalized geriatric patients.