Rational drug prescribing for elderly inpatients in a Brazilian hospital: A pilot study

Inadequate prescriptions are one of the biggest causes of adverse events related to medications. The aim of this study was to evaluate rational drug prescribing for elderly inpatients. A cross-sectional study was conducted to monitor the quality of drug prescriptions of patients admitted from May to August 2009, in a cardiovascular ward in Brazil. The quality evaluation of drug prescribing for elderly inpatient medication appropriateness was assessed by detection of potentially inappropriate medications, therapeutic duplicity and drug interactions. A total of 62 elderly inpatients were included, 71% were female, median age was 77.5 years. Number of medications prescribed was 3818, ranging from 3 to 25 medications per prescription. Polypharmacy was highly common (86%) in analyzed prescriptions. 370 prescriptions were analyzed (6 prescriptions per patient). We reviewed 370 medication orders (3818 prescribed drugs), 34% of which had at least one potentially inappropriate medication for the elderly, 70% presented therapeutic duplicity. Drug interactions were detected in 77% of prescriptions. Positive associations were observed between therapeutic duplicity and potentially inappropriate medications and between therapeutic duplicity and severe drug interactions. Our study show high rate of inappropriate prescriptions, which can influence the effectiveness of pharmacotherapy as much as the elderly safety. Key words: Rational drug prescribing, elderly, inpatients.