North Texas Research Forum 2024



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North Texas


Medical City Weatherford


Internal Medicine

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Internal Medicine | Medicine and Health Sciences | Therapeutics


Polypharmacy is a ubiquitous concern among patients, especially geriatric patients, who are at a higher risk of clinical burden. It is associated with an increase in healthcare costs, decreased functional status, and adverse drug events, contributing to geriatric syndromes, such as falls, cognitive decline, and urinary retention. Geriatric care is multi-tiered, requiring assistance and care from a thorough physician who is attune to the potential risks of medications that are commonly prescribed. Smaller communities, often with less resources and clinical providers and with an aging population, especially at the hospital setting, are vulnerable to oversights when it comes to medication reconciliation. We performed a prospective assessment of inpatient hospital admissions for patients over 70 years old, presenting with altered mental status, one of the common geriatric syndromes. Medication records were reviewed and evaluated for inappropriate medications per the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults (BEERS) inpatient records were reviewed to determine if medications were appropriately reviewed and reconciled. The flow chart of study cohort and the outcomes of a pilot group of 10 patients who met the eligibility criteria of the study are shown in Supplementary Fig. S1 respectively. The median (inter-quartile range, IQR) age of the participants was 84.4 years (70-95 years), among whom 40.0 % were men, and 60% percent were over 85. In the study population, the mean (standard deviation, SD) and median (IQR) numbers of daily prescribed medications were 12.2 and 11.5 (5.0–24.0), respectively. There was no age associated correlation with the number of prescriptions, especially those presented on the BEERS. Individuals who were prescribed with a greater number of medications were more likely to have renal impairment. Overall, the distributions of sex were similar across the groups. There was a higher distribution of patients in the third age group. The majority of patients were noted to be on appropriate medications after a thorough review of the BEERS criteria. Specifically, 6.7% of home medications reviewed were PIP per the Beers criteria. And out of that, only about 2.0 % or medications were continued. A larger sample size would improve the strength of the project and could include opportunities to address common medications that are well-known and prescribed to be potentially inappropriate if age-related dosing adjustments are not made, such as Rivaroxaban. A longitudinal review could also shed light on other secondary outcomes such as hospitalization stays and discharge destinations.

Original Publisher

HCA Healthcare Graduate Medical Education

Polypharmacy and Potentially Inappropriate Prescribing in Geriatric Population



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