Inappropriate prescribing in an older ED population.

Area of Science:

• Geriatrics
• Clinical Pharmacy
• Emergency Medicine

Background:

• Older adults frequently present to emergency departments (EDs).
• The use of potentially inappropriate medications (PIMs) in this demographic is a significant concern.
• The 2002 Beers criteria provide updated guidelines for identifying PIMs.

Purpose of the Study:

• To determine the prevalence of PIM use among elderly patients in the ED.
• To identify the most common PIMs prescribed to older ED patients.
• To assess PIM prescribing in patients discharged from the ED.

Main Methods:

• Retrospective analysis of 352 ED visits by patients aged 65 years and older.
• Medication review at the time of ED presentation.
• Analysis of new prescriptions given upon discharge from the ED.
• Application of the 2002 Beers criteria for PIM identification.

Main Results:

• 32% of older ED patients (111/352) were taking at least one PIM.
• Common PIMs included propoxyphene/acetaminophen, muscle relaxants, and antihistamines.
• 13% of patients discharged home (13/101) received new PIM prescriptions.

Conclusions:

• Outpatient PIM use is highly prevalent in older emergency department patients.
• There is a critical need for enhanced education on prescribing practices for this population.
• Interventions targeting PIM reduction in older ED patients are warranted.