Prevalence and risk factors for inappropriate drug use among older people: results from an Indian public outpatient setting

To determine the prevalence and risk factors associated with prescribing of inappropriate drugs using Modified Beers' criteria 2003, in older patients consulting medical specialists at a Geriatric Outpatient Clinic in India. This was a prospective interventional study with 1081 participants aged 60 years or over, of both sexes. The average number of medications was 6.32±0.08. Only 117 patients were prescribed at least one inappropriate drug (10.8%). Out of these, 112 received only one inappropriate drug while five patients received two. Therefore, there were 122 cases of inappropriate drug use (IDU; 11.28%). The two most commonly used inappropriate drugs were short-acting benzodiazepines and amitriptyline. According to the first list of the Beers' criteria, 112 instances of IDU were found, with only 10 instances of IDU from the second list. Logistic regression analysis showed that age over 70 years, multiple diagnoses, polypharmacy and a longer duration of treatment were risk factors for IDU. The assessment of IDU among older outpatients from an Indian public hospital has shown a lower prevalence of IDU compared with other countries. The findings of this study illustrate the need to bring the finer issues concerned with geriatric pharmacotherapy to the attention of physicians, since the physicians involved in this study accepted the recommendations made by the investigator.