Document Type : Original Article
Authors
1 Department of Pharmacy Practice, Indo‑Soviet Friendship College of Pharmacy, Moga, Punjab, India
2 University Centre of Excellence in Research, Baba Farid University of Health Sciences, Faridkot, Punjab, India
3 Department of Health Research, Ministry of Family and Welfare, Govt. of India, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
Abstract
BACKGROUND: Potentially inappropriate medication (PIM) prevalence in older adults is increasing
day by day due to lack of knowledge among medical students and professionals.
OBJECTIVE: To determine the knowledge of medical students toward American Geriatric
Society (AGS) Beers criteria for PIM prescribing.
MATERIALS AND METHODS: This cross‑sectional study employed a self‑administered questionnaire
which was validated and designed to assess the knowledge, attitude, and practice of medical interns
and postgraduate residents on Beers criteria for PIMs in older adults. The study was conducted
in Faridkot region of Punjab in 2019. This study will utilize a purposive sampling strategy and a
convenience sampling of up to 183 participants. Mann–Whitney U or Kruskal–Wallis tests were used
to compare different issues as appropriate. P values of <0.05 were considered significant.
RESULTS: Out of 183 questionnaires distributed, only 155 participants (response rate 84.6%) had
filled the survey and were included in the study. 61.3% (n = 95) of the respondents were males. The
mean knowledge score of 155 participants was (5.16 ± 1.56), where the highest score was 9 and the
lowest score was 2 out of 10. 15.5% (n = 24) of the participant strongly agreed that Beers criteria use
is necessary in clinical setting and would be very helpful. While 22.5% (n = 35) of the participants
strongly agreed that PIMs cause adverse drug event (ADE) and drug‑related problems (DRPs) in
older adults. Age of the participant had a significant effect on the knowledge score (p = 0.009), and
participant aged between 31 and 40 years had significantly higher knowledge scores compared with
participants falls under 20–30 years.
CONCLUSION: Medical students and postgraduate residents had average knowledge of PIMs and
are unaware of the standard guidelines in older adults such as the Beers criteria. Lack of formal
education or training about Beers guidelines was the main reason responsible for average knowledge
among participants.
Keywords
- Werner CA. The Older Population, 2010. US Department of
Commerce, Economics and Statistics Administration, US, 2011.
2. Gavrilov LA, Heuveline P. Aging of population. The encyclopedia
of population 2003;1:32–7.
3. Chakraborti RD. The Greying of India: Population Ageing in the
Context of Asia. Sage; 2004.
4. Organization WH. World Health Statistics 2015. World Health
Organization; 2015.
5. Turnheim K. When drug therapy gets old: Pharmacokinetics and
pharmacodynamics in the elderly. Exp Gerontol 2003;38:843–5.
6. Jones JK. Assessing potential risk of drugs: The elusive target.
Ann Intern Med 1992;117:691–2.
7. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J,
Beck JC. Explicit criteria for determining inappropriate medication
use in nursing home residents. Arch Intern Med 1991;151:1825–32.
8. McLeod PJ, Huang AR, Tamblyn RM, Gayton DC. Defining
inappropriate practices in prescribing for elderly people:
A national consensus panel. CMAJ 1997;156:385–91.
9. Hanlon JT, Schmader KE, Koronkowski MJ, Weinberger M,
Landsman PB, Samsa GP, et al. Adverse drug events in high risk
older outpatients. J Am Geriatr Soc 1997;45:945–8.
10. Beers MH. Explicit criteria for determining potentially
inappropriate medication use by the elderly: An update. Arch
Intern Med 1997;157:1531–6.
11. Waller JL, Maclean JR. Updating the Beers criteria for potentially
inappropriate medication use in older adults. Arch Intern Med
2003;163:2716–24.
12. FickDM, SemlaTP, SteinmanM, BeizerJ, BrandtN, DombrowskiR,
et al. American Geriatrics Society 2019 updated AGS Beers
Criteria® for potentially inappropriate medication use in older
adults. J Am Geriatr Soc 2019;67:674–94.
13. Sharma R, Arora M, Garg R, Bansal P. A closer look at the 2019
Beers criteria. Drugs Ther Perspect 2020;36:116–22.
14. Ramaswamy R, Maio V, Diamond JJ, Talati AR, Hartmann CW,
Arenson C, et al. Potentially inappropriate prescribing in elderly:
Assessing doctor knowledge, confidence and barriers. J Eval Clin
Pract 2011;17:1153–9.
15. Ma Z, Zhang C, Cui X, Liu L. Comparison of three criteria for
potentially inappropriate medications in Chinese older adults.
Clin Interv Aging 2019;14:65.
16. Davidoff AJ, Miller GE, Sarpong EM, Yang E, Brandt N, Fick DM.
Prevalence of potentially inappropriate medication use in older
adults using the 2012 Beers criteria. J Am Geriatr Soc 2015;63:486–
500.
17. Egger SS, BachmannA, HubmannN, SchliengerRG, Krähenbühl S.
Prevalence of potentially inappropriate medication use in elderly
patients. Drugs Aging 2006;23:823–37.
18. Nagendra Vishwas H, Harugeri A, Parthasarathi G, Ramesh M.
Potentially inappropriate medication use in Indian elderly:
Comparison of Beers’ criteria and Screening Tool of Older
Persons’ potentially inappropriate Prescriptions. Geriatr Gerontol
Int 2012;12:506–14.
19. Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi C. Utilization of
potentially inappropriate medications in elderly patients in
a tertiary care teaching hospital in India. Perspect Clin Res
2014;5:184.
20. Zhang X, Zhou S, Pan K, Li X, Zhao X, Zhou Y, et al. Potentially
inappropriate medications in hospitalized older patients:
A cross‑sectional study using the Beers 2015 criteria versus the
2012 criteria. Clin Interv Aging 2017;12:1697.
21. Fu AZ, Jiang JZ, Reeves JH, Fincham JE, Liu GG,
Perri III M. Potentially inappropriate medication use and
healthcare expenditures in the US community‑dwelling elderly.
Med Care 2007;45:472–6.
22. CorI. IBM SPSS Statistics for Windows, Version24.0. Armonk(NY):
IBM Corp; 2016.
23. Keyfitz N, Flieger W. World Population Growth and Aging.
University of Chicago Press Economics Books; 1991. - 24. Shin KR, Kim JS. A study on health concern, self‑rated health,
health status, and health promotion behavior of elderly women
in urban area. J Korean Acad Nurs 2004;34:869–80.
25. Detmar SB, Muller MJ, Schornagel JH, Wever LD, Aaronson NK.
Health‑related quality‑of‑life assessments and patient‑physician
communication: A randomized controlled trial. JAMA
2002;288:3027–34.
26. Rajan SI, Mishra US, Sarma PS. Health concerns among India’s
elderly. Int J Aging Hum Dev 2001;53:181–94.
27. NobakhtS, ShirdelA, Molavi-TaleghaniY, DoustmohammadiMM,
Sheikhbardsiri H. Human resources for health: A narrative
review of adequacy and distribution of clinical and nonclinical
human resources in hospitals of Iran. Int J Health Plan Manag
2018;33:560–72.
28. Mohammadi MM, Sheikhasadi H, Mahani SA, Taheri A,
Sheikhbardsiri H, Abdi K. The effect of bio ethical principles
education on ethical attitude of prehospital paramedic personnel.
J Educ Health Promot 2021;10:289.
29. Dimitrow MS, Airaksinen MS, Kivelä SL, Lyles A, Leikola SN.
Comparison of prescribing criteria to evaluate the appropriateness
of drug treatment in individuals aged 65 and older: A systematic
review. J Am Geriatr Soc 2011;59:1521–30.
30. Salbu RL, FeuerJ. A closer look at the 2015 Beers criteria. J Pharm
Pract 2017;30:419–24.
31. Planton J, Edlund BJ. Strategies for reducing polypharmacy in
older adults. J Gerontol Nurs 2010;36:8–12.
32. Coulter A, Ellins J. Effectiveness of strategies for informing,
educating, and involving patients. BMJ 2007;335:24–7.
33. Sheikhbardsiri H, Mousavi SH, Doustmohammadi MM,
Karimi M, Salahi S. The effect of educational workshop on
emergency department nurses’ self‑efficacy in patient training.
J Educ Health Promot 2019;8:136.
34. Sheikhbardsiri H, Sheikhasadi H, Mahani SA, Mohamadi MM.
Emotional intelligence and learning strategies of postgraduate
students at Kerman University of Medical Sciences in the
southeast of Iran. J Educ Health Promot 2020;9:66.
35. Sarani A, Mousavi SH, Salahi S, Hasani F, Abdar ZE,
Sheikhbardsiri H. Emotional Intelligence and Self‑Efficacy among
deputy’s administrative staff of Kerman University of Medical
Sciences. J Educ Health Promot 2020;9:105.
)