Merin Levy Philip

The growing geriatric population in India presents significant healthcare challenges, particularly regarding the safe and effective use of medications. This prospective, observational study was conducted over 10 months at a tertiary care hospital in Coimbatore to evaluate the use of potentially inappropriate medications (PIMs) among elderly patients using the 2023 Beers Criteria and to assess their impact on quality of life (QoL). Seventy-six patients aged 65 years and above were screened. Over 47% of prescriptions contained at least one PIM, with pantoprazole being the most frequently identified. The presence of multiple comorbidities and polypharmacy were common, leading to a high incidence of drug-drug interactions, including several with major severity. QoL was measured using the FANLTC-FACIT scale and revealed moderate scores in physical, social, and functional domains but notably lower scores in emotional well-being, particularly among female patients. The findings emphasize the need for clinical vigilance, routine prescription audits, and interprofessional collaboration to minimize PIMs and optimize pharmacotherapy in elderly care. Implementation of rational medication review and withdrawal strategies, along with adherence to updated geriatric prescribing guidelines among elderly patients, could substantially enhance QoL outcomes and reduce healthcare burdens.

BACKGROUND Drug is a double edged sword, despite its benefits, is been always associated with adverse experiences. We conducted a Questionnaire Survey on role of healthcare professionals in detecting, reporting and documenting adverse drug reactions. METHODS A self-administered Questionnaire Survey was conducted to know the attitude, knowledge and practice oriented issues prevailing among the study site and among the healthcare professionals. Patients admitted to General Medicine Department over a period of 9 months were assessed for ADRs through daily ward visit by the pharmacist. A total of 51 ADRs were identified in 3722 general medicine ward admissions during the study period. RESULTS Severity of the suspected ADRs assessed using Modified Hartwig and Siegel Scale, revealed that 4(7.8%) suspected ADRs were severe, 27 (52.94%) ADRs were moderate and 20 (39.21%) ADRs were mild in severity. The study revealed that 29 (56.8%) ADRs were possibly drug-related, whereas 17 (33.33%) were classified as probably or definitely related to the drug and 22(43.13%) ADRs were possibly drug-related, 16(31.41%) ADRs were probably drug-related, whereas 11(21.56%) were classified as certainly related to drug on assessment with Naranjo and WHO scale.12 patients (23.52%) were admitted due to an Adverse Drug Reaction compared to 39(76.47%) who were affected by ADR after hospital admission. The majority (40%) of patients who suffered from ADRs were above 60 years. System most commonly affected were Dermatological in -15(29.41%) patients, Gastrointestinal in 13 (25.49%) patients, CNS in 8(15.68%) patients, followed by Cardiovascular in 2 (3.92%) patients. The drug class mostly associated with ADR was Antibiotics in 16(31.3%) cases, followed by NSAID in 8(15.68%). In 41 (80.34%) cases the drug was withdrawn, dose altered in 7(15.6%) and no change was made in 3(5.8%) patients. Adverse reactions encountered were treated and the final outcome was measured. About 43(84.3%) patients recovered, while in 7(13.7%) cases the ADRs decreased. One fatal case was reported. CONCLUSION The study strongly suggests that there is greater need for streamlining of hospital based ADR reporting and monitoring system to create awareness and to promote the reporting of ADR among healthcare professionals of the country. Our study revealed that pharmacists' involvement could not only greatly increase the reporting rate but also quality reporting.