Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Basic and Clinical Physiology and Pharmacology

Editor-in-Chief: Horowitz, Michal

Editorial Board: Das, Kusal K. / Epstein, Yoram / S. Gershon MD, Elliot / Kodesh , Einat / Kohen, Ron / Lichtstein, David / Maloyan, Alina / Mechoulam, Raphael / Roth, Joachim / Schneider, Suzanne / Shohami, Esther / Sohmer, Haim / Yoshikawa, Toshikazu / Tam, Joseph

CiteScore 2016: 1.01

SCImago Journal Rank (SJR) 2016: 0.349
Source Normalized Impact per Paper (SNIP) 2016: 0.495

See all formats and pricing
More options …
Volume 26, Issue 4


Identification and evaluation of potentially inappropriate medications (PIMs) in hospitalized geriatric patients using Beers criteria

Pattani Danisha
  • Department of Pharmacy Practice, Al Shifa College of Pharmacy, Poonthanam, Khizhattur, Perinthalmanna, Kerala, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Chandrasekhar Dilip
  • Corresponding author
  • Department of Pharmacy Practice, Al Shifa College of Pharmacy, Poonthanam, Khizhattur, Perinthalmanna, Kerala, India
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Panakkal Linu Mohan
  • Department of Pharmacy Practice, Al Shifa College of Pharmacy, Poonthanam, Khizhattur, Perinthalmanna, Kerala, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Cholamugath Shinu
  • Department of Pharmacy Practice, Al Shifa College of Pharmacy, Poonthanam, Khizhattur, Perinthalmanna, Kerala, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Jaffer Chalil Parambil
  • Department of General Medicine, Kims Alshifa Superspeciality Hospital, Perinthalmanna, Kerala, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Muhammed Sajid
Published Online: 2015-05-07 | DOI: https://doi.org/10.1515/jbcpp-2014-0054


Background: The aim of the study was to identify and evaluate potentially inappropriate medication (PIM) in geriatric patients using Beers criteria and also to identify adverse drug events (ADEs) due to PIMs and various drug-drug interactions.

Methods: The medications in the prescriptions of patients above 60 years of age, their dosage regimen respective of their diagnosis were analyzed. Each medication was then checked with Beers list tables, and any medication if mentioned in the Beers list, was noted along with its strength of recommendation and quality of evidence. Any adverse drug event (ADE) due to PIM was identified. Causality of the events was assessed by Naranjo’s Scale. The number of drug-drug interactions per prescription and the severity of each interaction were also analyzed. The collected data from 200 subjects were subjected to statistical treatments using Statistical Package for Social Sciences (SPSS) software version 16.0 for WINDOWS.

Results: Based on the Beers criteria 2012, 106 out of 200 (53%) prescriptions had at least one PIM prescribed. A sum of 1690 medications was prescribed as a whole for the entire study subjects. Among which, 134 PIMs were identified. Most commonly prescribed PIMs were benzodiazepines (39, 19.5%), followed by sliding scale use of insulin (31, 15.5%), and prazosin at a rate of 11.5% (23). A total of 10 ADEs were identified during the study. The average number of drug interactions observed among total samples was found to be 3.0±6.0 with 0±5.0 serious interactions, 2±4.0 significant interactions requiring close monitoring, and 0±6.0 minor interactions.

Conclusions: The study shows high prevalence of prescribing PIMs in hospitalized elderly patients; PIM also caused incidence of ADEs; and serious drug-drug interactions were scarce among the patients.

Keywords: adverse drug events; Beers criteria; elderly; potentially inappropriate medications


  • 1.

    Berdot S, Bertrand M, Dartigues J-F, Fourrier A, Tavernier B, Ritchie K, et al. Inappropriate medication use and risk of falls – a prospective study in a large community-dwelling elderly cohort. BMC Geriatr 2009;9:30:1471–2318.Google Scholar

  • 2.

    Gallagher PF, Barry PJ, Riyan C, Hartigan I, Mahony DO. Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beer’s criteria. Age Aging 2008;37:96–101.Google Scholar

  • 3.

    Hamilton HJ, Gallagher PF, Mahony DO. Inappropriate prescribing and adverse drug events in older people. BMC Geriatr 2009;9:5.PubMedCrossrefGoogle Scholar

  • 4.

    Shah RB Gajjar BM, Desai SV. Evaluation of the appropriateness of prescribing in geriatric patients using Beer’s criteria and Phadke’s criteria and comparison thereof. J Pharmacol Pharmacother 2011;2:248–52.CrossrefGoogle Scholar

  • 5.

    Rancourt C, Moisan J, Baillargeon L, Verreault R, Laurin D, Gregoire JP. Potentially inappropriate prescriptions for older patients in long term care. BMC Geriatr 2004;4:9 (doi:10.1186/1471-2318-4-9).PubMedCrossrefGoogle Scholar

  • 6.

    Taskeen M, Anitha N, Ali SR, Rao B, Khan AB. A study on rational drug prescribing pattern in geriatric patients in Hyderabad metropolitan. J Drug Delivery Therapeut 2012;2:109–13.Google Scholar

  • 7.

    Hustey FM. Beer’s criteria and ED: an adequate standard for inappropriate prescribing? Am J Emerg Med 2008;26:695–6.Web of ScienceCrossrefGoogle Scholar

  • 8.

    Monroe T, Carter M, Parish A. A case study using the list criteria to compare prescribing by family practitioners and geriatric specialists in a rural nursing home. Geriatr Nurs 2011;32:350–6.CrossrefWeb of ScienceGoogle Scholar

  • 9.

    Olsson IN, Runnamo R, Engfeldt P. Drug treatment in elderly: an intervention in primary care to enhance prescription quality and quality of life. Scand J Public Health 2012;30:3–9.Web of ScienceGoogle Scholar

  • 10.

    Moumin TG. Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: a comparison between Beer’s 2003 and 2012 criteria. Indian J Pharmacol 2013;45:603–7.Web of ScienceGoogle Scholar

  • 11.

    Harugeri A, Joseph J, Parthasarathi G, Ramesh M, Guido S. Potentially inappropriate medication use in elderly patients: a study of prevalence and predictors in two teaching hospitals. J Postgrad Med 2010;56:186–91.PubMedWeb of ScienceGoogle Scholar

  • 12.

    Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 2010;107:543–51.Web of SciencePubMedGoogle Scholar

  • 13.

    Zaveri HG, Mansuri SM, Patel VJ. Use of potentially inappropriate medicines in elderly: a prospective study in medicine outpatient department of a tertiary care teaching hospital. Indian J Pharmacol 2010;42:95–8.PubMedGoogle Scholar

  • 14.

    Fadare JO, Agboola SM, Opeke OA, Alabi RA. Prescription pattern and prevalence of potentially inappropriate medications among elderly patients in Nigerian rural tertiary hospital. Ther Clin Risk Mang 2013;9:115–20.Web of ScienceGoogle Scholar

  • 15.

    The American Geriatric Society 2012 Criteria Update Expert Panel. American geriatric society updated beer’s criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2012;60:616–31. Published online 2012 Feb 29. doi: 10.1111/j.1532-5415.2012.03923.x.CrossrefGoogle Scholar

  • 16.

    Skaar DD, O’Connor HL. Use of criteria to identify potentially inappropriate drug use in community-dwelling older dental patients. Oral Pathol Oral Radiol 2012;113:714–21.Web of ScienceCrossrefGoogle Scholar

  • 17.

    Page RL, Linnebur SA, Lucinda LB, Ruscin JM. Inappropriate prescribing in the hospitalized elderly patient: defining the problem, evaluation tools, and possible solutions. Clin Interv Aging 2010;5:75–87.CrossrefPubMedGoogle Scholar

  • 18.

    Bakken MS, Ranhoff AH, Engeland A, Ruths S. Inappropriate prescribing for older people admitted to an intermediate care nursing home unit and hospital wards. Scand J Prim Health 2012;30:169–75.CrossrefWeb of ScienceGoogle Scholar

  • 19.

    Laroche M-L, Charmes J-P, Nouaille Y, Picard N, Merle L. Is inappropriate medication use a major cause of adverse drug reactions in the elderly? Br J Clin Pharmacol 2006;63177–86.Google Scholar

About the article

Corresponding author: Dr. Chandrasekhar Dilip, Prof and Head, Department of Pharmacy Practice, Al Shifa college of Pharmacy, Poonthavanam P.0, Perinthalmanna, Kerala 679325, India, E-mail:

Received: 2014-04-30

Accepted: 2015-02-12

Published Online: 2015-05-07

Published in Print: 2015-07-01

Citation Information: Journal of Basic and Clinical Physiology and Pharmacology, Volume 26, Issue 4, Pages 403–410, ISSN (Online) 2191-0286, ISSN (Print) 0792-6855, DOI: https://doi.org/10.1515/jbcpp-2014-0054.

Export Citation

©2015 by De Gruyter.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Claudio Garay-Bravo, A. Peña, M. Molina, J. Sanfeliu, P. Piles, P. Blasco, and J. Salazar
European Geriatric Medicine, 2018
Fabrizio Colombo, Pietro Nunnari, Giovanni Ceccarelli, Angelo Valerio Romano, Pietro Barbieri, and Francesco Scaglione
The Journal of Clinical Pharmacology, 2018
Ana Carmen dos Santos Ribeiro Simoe Juliano, Alessandra Lamas Granero Lucchetti, Jéssica Teixeira Santos da Silva, Letícia Gomes Santos, Jéssica Borges Taranto Nunes, Guilherme Cortes Fernandes, and Giancarlo Lucchetti
Journal of the American Geriatrics Society, 2017
Priscila Horta Novaes, Danielle Teles da Cruz, Alessandra Lamas Granero Lucchetti, Isabel Cristina Gonçalves Leite, and Giancarlo Lucchetti
Geriatrics & Gerontology International, 2017
Mandavi Kashyap, Sanjay D’Cruz, Atul Sachdev, and Pramil Tiwari
International Journal of Risk & Safety in Medicine, 2015, Volume 27, Number 4, Page 209
Paul S. García, Elizabeth W. Duggan, Ian L. McCullough, Simon C. Lee, and David Fishman
Clinical Therapeutics, 2015, Volume 37, Number 12, Page 2651

Comments (0)

Please log in or register to comment.
Log in