Potentially Inappropriate Medications and Drug–Drug Interactions in Geriatrics Cardiac Patients Visiting to Tertiary Care Central Hospital of Nepal

Abstract

Objective

Potentially Inappropriate Medications (PIMs) and Drug–Drug Interactions (DDIs) among geriatrics are a prominent issue and place a considerable burden on the quality health outcome. This study aimed to assess PIMs and DDIs particularly among geriatric cardiac elderly patients attending the outpatient department of a tertiary care hospital of Nepal.

Methodology

A prospective cross-sectional study was conducted on geriatrics patients (≥ 65 years) attending the cardiology out-patient department of Bharatpur Central Hospital, Nepal. Beers criteria were used to assess PIM, and Medscape software was employed to assess DDIs. Regression analysis was performed to identify the predictors of PIM and DDIs experienced by patients.

Results

A total of 140 geriatric patients were enrolled in the study. A total of 683 drugs were prescribed to them, with an average of 4.59 medications per patient. 23.6% and 65% of patients were found to be prescribed PIMs and encountered DDIs, respectively. Proton Pump Inhibitors (PPI) (66.67%) were the most prescribed PIMs and involved in identified DDIs. The removal of PIMs was calculated to reduce 11.72% of the cost of patients prescribed PIMs and 19.88% of identified DDIs. The number of medications prescribed was found to be a significant predictor for PIM (Odd Ratio: 1.352) and DDIs (Odd Ratio: 2.217) encountered.

Conclusion

This study highlights the concerning prevalence of potentially inappropriate medication and drug–drug interactions among ambulatory cardiac elderly patients. Integration of regular medication audits and evidence-based prescribing practices is essential to optimize pharmacological management and enhance patient safety.