Role of Medication Therapy Management Pharmacists in Estimating and Minimizing Inappropriate Prescriptions in Geriatric Patients with Cardiovascular Diseases- A Cross-Sectional Study

Geriatrics is a sub-specialty of family medicines and internal medicines which focus on the health care of older adults. Geriatric populations are more prone to polypharmacy. The purpose of this study is to determine the prescribing patterns in geriatric patients with cardiovascular diseases and to study the prevalence of inappropriateness in prescriptions in a tertiary care hospital. The study is to analyze the prescribing patterns using WHO core drug use indicators and potentially inappropriate medications using BEER’S criteria 2019. OBJECTIVE •To identify prescriptions with potentially inappropriate medications in elderly patients diagnosed with cardiovascular diseases using Beer’s Criteria. •To assess the drug use patterns in geriatric patients with cardiovascular diseases using WHO prescribing indicators. •To determine the applicability of Beer’s criteria as a polypharmacy reduction strategy in Indian geriatric population. METHODOLOGY Study Design : A Prospective, Cross-Sectional, Observational study Study Duration : Ten months (January 2019- October 2019) Study Setting : Cardiology department A regular ward rounds was carried out in the Cardiology Department. The patients were educated about the study. The willing patients were allowed to sign the informed consent form. The data was collected using specially designed data entry form. Prescriptions of willing patients were collected for the study and the pattern was analyzed using WHO core drug use indicators and the appropriateness of the prescribed medications was evaluated by BEER’s criteria. Abstract Role of Medication Therapy Management Pharmacists in Estimating and Minimizing Inappropriate Prescriptions in Geriatric patients with Cardiovascular Diseases- A Cross-Sectional Study. RESULTS AND DISCUSSION The data from 240 patients admitted to cardiology department were collected. The study shows that out of 240 patients, 55.83% (134) of the patients were males and 44.17% (106) were females. The prescribing patterns were analyzed using WHO core drug use indicators and found out the average number of drugs per prescription is 6.66, percentage of drugs prescribed by generic name is 10.36, percentage of encounters with an antibiotic prescribed is 5.68, percentage of encounters with an injection prescribed is 26.97, percentage of drugs prescribed from essential drugs list is 77.14. Out of 240 prescriptions, 64.16% of the prescriptions were found to be appropriate and 35.83% were found to be inappropriate according to BEERS criteria. Aspirin (27.9%), Atropine(11.62), Amiodarone (9.3%), Digoxin (9.3%), chlorpheniramine (6.97) and glibenclamide (2.32%) should be avoided or dosage adjusted. Tramadol (18.6%) should be used with caution in geriatric patients. Spironolactone (4.65%) should be avoided or dosage reduced with varying levels of kidney function in geriatric patients. CONCLUSION Rationality of drug use can be identified using WHO prescribing indicators. The use of potentially inappropriate medications can be avoided using the Beers criteria 2019, which is one of the important clinical tools which can be wisely used by physicians, pharmacists and health care professionals. The role of medication therapy management pharmacist is to assess the appropriateness of the prescriptions to increase the quality of medical care given to geriatrics. Pharmacists can give intervention to the physician about the drugs and can suggest better and safer alternative to the geriatrics