title: Evidence-based information leads to reduction in inappropriate drug prescribing: Results from Indian older inpatients.
abstract: BACKGROUND
  Although several guidelines for appropriate prescribing are available, inappropriate drug prescription remains noteworthy problem among older adults. Indian older patients are also not spare from this issue and existing literature indicates a fair level of inappropriate drug use (IDU).
  
  
  OBJECTIVE
  Identified potentially IDU and documented their reduction based on provided evidence-based information and also identified possible predictors of IDU in older inpatients.
  
  
  METHODS
  Three years prospective study included 1510 inpatients aged 60 years or over, of both sexes. IDU identified using the Modified Updated AGS Beers Criteria 2012.
  
  
  RESULTS
  The patients had an average age of 67.10 ± 0.23 years and on an average were prescribed 9.29 ± 0.11 medications. Using AGS Beers Criteria 2012, total IDU was found to be 21% (n = 325). Of total 287 patients received only one inappropriate drug whereas 38 patients received two or more inappropriate drug(s). According to first list of criteria long acting benzodiazepines, anticholinergics, nitrofurantoin and digoxin were most common IDU. Prescription of theophylline in insomnia followed by aspirin in gastric ulcer and calcium channel blocker in constipation were listed from second list of criteria. 31% reductions in IDU were observed based on evidence-based information regarding each identified inappropriate drugs.
  
  
  CONCLUSIONS
  The findings of this study provide evidence that provision of unbiased evidenced based information is the best possible means for improvement of pharmacotherapy in older patients.
authors.affiliation: Faculty of Pharmacy, AIMST University, Malaysia.
authors.forename: Mandavi
authors.initials: M
authors.lastname: Kashyap
authors.affiliation: Department of General Medicine, GovernmentMedical College & Hospital, Chandigarh, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: D'Cruz
authors.affiliation: Department of General Medicine, GovernmentMedical College & Hospital, Chandigarh, India.
authors.forename: Atul
authors.initials: A
authors.lastname: Sachdev
authors.affiliation: Department of Pharmacy Practice, National Instituteof Pharmaceutical Education and Research, S.A.S. Nagar, Punjab, India.
authors.forename: Pramil
authors.initials: P
authors.lastname: Tiwari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019317:Evidence-Based Medicine / Q000592:standards*; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007194:India / Q000453:epidemiology; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D000067561:Potentially Inappropriate Medication List / Q000592:standards* / Q000706:statistics & numerical data; D011446:Prospective Studies
keywords: AGS Beers criteria 2012; IDU; India; Older adults; inpatient