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Re: Prevalence and Determinants of Use of Potentially Inappropriate Medications in Elderly Inpatients: A Prospective Study in a Tertiary Healthcare Setting K. Undela, D. Bansal, S. D’Cruz, A. Sachdev and P. Tiwari Department of Pharmacy Practice, JSS College of Pharmacy, JSS University, Mysore, Karnataka, India Geriatr Gerontol Int 2014; 14: 251e258.

Abstract for this article http://dx.doi.org/10.1016/j.juro.2014.12.074 available at http://jurology.com/ Editorial Comment: Older adults can be particularly prone to adverse effects of medications due to underlying changes in hepatic and renal metabolism, drug-drug interactions, polypharmacy and other factors associated with aging. Avoidance and reduction of use of potentially inappropriate medications (PIMs) have become important targets for optimal geriatric care. This study examined patterns of PIM prescriptions among geriatric inpatients at a tertiary academic medical center in India. A total of 81 of 502 inpatients (16.1%) were prescribed at least 1 PIM. Identified risk factors included age 80 years or older, male gender, having more than 3 diagnoses, polypharmacy with 6 or more medications and hospital stay 10 days or longer. These factors may reflect greater comorbidity and illness severity as underlying risks. The most commonly prescribed PIMs in this study included amiodarone, digoxin and amitriptyline. Among the more common urological medications nitrofurantoin is identified as a PIM in patients with decreased renal function (creatinine clearance less than 60 ml per minute) or for chronic prophylaxis due to risks of pulmonary complications, and was commonly prescribed in this study (18.2% of patients). It is noteworthy that some medications generally identified as PIMs may be appropriate for use in specific instances in select patients with proper clinical justification. Although the authors did not examine methods to reduce PIM prescription among geriatric patients, other series have shown that this is feasible in the inpatient and outpatient settings.1 This study does highlight the fact that increased geriatric populations and associated clinical challenges are, indeed, a global issue. Tomas L. Griebling, MD, MPH 1. The American Geriatrics Society 2012 Beers Criteria Update Expert Panel: American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012; 60: 616.

Re: Prevalence and determinants of use of potentially inappropriate medications in elderly inpatients: a prospective study in a tertiary healthcare setting.

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