ORIGINAL RESEARCH ARTICLE Assessment of inappropriate medication use in elderly inpatients of a tertiary care hospital in south-eastern India using the modified updated Beers criteria 2003 Pradeep Devarapalli 1,2 • Seema Soni 3 • Raja Kiranmai T.K.N.V 1,2 • Swaraj G 1,2 • Sudhakar Babu A.M.S 2 Ó Springer International Publishing AG 2017 Abstract Background Inappropriate medication use (IMU) in the elderly population is an issue in disease management and healthcare provision. The aim of this observational 6-month study was to assess the prevalence and predictors of inappropriate prescribing and evaluate drug-related problems and morbidity in a geriatric inpatient population. Methods The study was conducted in all departments of a tertiary care hospital, reviewing the prescriptions of 135 elderly (aged C60 years) patients selected by randomised sampling. The modified updated Beers criteria 2003 were used to determine the prevalence of IMU. Results Of the selected patients, 25.9% (i.e. 35 of the 135 patients) were found to be receiving at least one inappro- priate medication, of which the most frequently used inappropriate medication was digoxin (48.6%). Out of 135 patients, 58 (43.0%) had an incidence of one or more drug interactions. Patients receiving at least one inappropriate medication had a higher possibility of having a drug interaction than patients who were not receiving any inappropriate medications. Conclusions The prevalence of inappropriate prescribing in this study is notable compared to the rates reported in other countries. Advanced age, polypharmacy, multiple comorbidities and long-term hospitalisation are the possi- ble aetiological factors of IMU. Background Elderly people are the largest consumers of medicines and healthcare resources in developed countries. Appropriate- ness in healthcare has been defined as ‘‘the outcomes of process of decision making that maximizes net health gains within society’s available resources’’[1]. Inappropriate medication use (IMU) in the elderly population is an issue in disease management and healthcare provision. The effort to reduce IMU in elderly patients is likely to have a sub- stantial impact on reducing drug-related morbidity. The assessment of the suitability of pharmacotherapy aims to modify and improve existing geriatric healthcare prac- tice(s). This is possible only when age-related problems are well studied and problems related to pharmacotherapy are identified. This prospective observational study was con- ducted to evaluate the quality of geriatric pharmacotherapy in a tertiary care hospital using the modified updated Beers criteria (2003) as a screening tool to determine the inap- propriateness of medication use. Inappropriateness Among the elderly IMU is a major health care issue [2]. In individual patients, IMU involves the identification of medications associated with the following: a high risk of harm to the patient when used in standard doses regardless of patient diagnosis or conditions; contraindications in patients with specific conditions; potentially harmful drug interactions with other concomitant medications; and therapeutic duplication with other concomitant medications [3]. As elderly patients often have complex drug regimens due to their age-related changes in drug pharmacokinetics and pharmacodynamics, adverse medication outcomes are & Pradeep Devarapalli pradeepdevarapalli4@gmail.com 1 A. M. Reddy Memorial College of Pharmacy, Guntur, Andhra Pradesh, India 2 Lalitha Super Specialty Hospital, Kothapet, Guntur, India 3 National Institute of Pharmaceutical Education and Research (NIPER), Punjab, India Drugs Ther Perspect DOI 10.1007/s40267-017-0442-6