Evaluation of potentially inappropriate psychotropic drugs as defined by beers criteria in elderly patients visiting medication therapy adherence clinic of psychiatry / Adilah Mohd Fazli

Introduction: Among studies carried out in Malaysian elderly patients, many focused on the issue of potentially inappropriate medications (PIMs) as defined by Beers criteria in inpatient setting and nursing home care. Therefore, this study is expected to give initial information on the prevalence and predictors of prescribing potentially inappropriate psychotropic drugs (PIPDs), as defined by Beers criteria among psychogeriatric patients in the outpatient setting. Objectives: To determine the prevalence and predictors of prescribing PIPDs among psychogeriatric patients visiting Medication Therapy Adherence Clinic (MTAC) of psychiatry in Hospital Tengku Ampuan Rahimah (HTAR). Methodology: A retrospective observational cohort study was conducted on 166 older patients > 60 years, came for follow up visits at MTAC psychiatry and were prescribed with at least 1 psychotropic drug. Beers criteria 2012 was used to determine whether each of the study subject being prescribed with PIPDs or not. Multiple logistic regressions analysis was performed to identify significant predictors of prescribing PIPDs from patient's characteristics. Any reported adverse outcomes (including reported adverse effects, falls, emergency room visits and hospitalizations) related to psychotropic drugs use were documented. Results: The prevalence of prescribing PIPDs to the psychogeriatric patients visiting MTAC psychiatry was 52.4% and benzodiazepines were the most commonly prescribed PIPDs. Number of children was the only significant predictor of prescribing PIPDs among the elderly patients (OR = 1.18; p = 0.015) and no significant association was observed between prescribing PIPDs and any of the adverse outcomes reported. Conclusion: Heterogeneity of the study subjects and variability in the study design contribute to the inconsistency of the study findings from other PIMs studies carried out elsewhere.