www.ijbcp.com International Journal of Basic & Clinical Pharmacology | November-December 2016 | Vol 5 | Issue 6 Page 2376 IJBCP International Journal of Basic & Clinical Pharmacology Print ISSN: 2319-2003 | Online ISSN: 2279-0780 Original Research Article Evaluation of inappropriate prescribing to the hospitalized elderly patients in Al Shifa hospital, Gaza, Palestine Lina K. Massoud*, Hala Z. Al Agha, Mahmoud H. Taleb INTRODUCTION Inappropriate prescribing (IP) is a single term that covers three concepts; under prescribing, overprescribing, and misprescribing. 1,2 Overprescribing relates to the practice of prescribing more medications than what are clinically required. 3 Under prescribing refers to the failure of prescribing drugs that are needed, 1 while misprescribing refers to incorrectly prescribing a drug that is needed in term of choice of medication, drug interactions, dose, duration of therapy, duplication and follow up. 2 Inappropriate prescribing (IP) is particularly relevant for the elderly (65 yrs or older), as they have the highest susceptibility to the effects of drugs. They experience age-related physiological changes, which often influence the pharmacokinetic and pharmacodynamic status of drugs. 4 Moreover, the elderly often have several concurrent illnesses that need several medications, thereby, increasing the risk of adverse drug events, drug- drug and drug-disease interactions. 5 A number of studies have investigated IP in the elderly. Different criteria have been used to identify IP; the most frequently cited one is Beers' criteria. The criteria are a list of potentially inappropriate medications (PIMs) that should be avoided in elderly, developed in 1991 for nursing homes and expanded and revised several times to include all setting of geriatric care. 6 The final updated criteria in 2012 are divided into three categories: PIMs and classes to avoid in older adults, PIMs and classes to avoid in older adults with certain diseases and syndromes that the drugs listed can exacerbate, and finally medications to be used with caution in older adults. 6 Data from those studies have shown a high prevalence of IP in ABSTRACT Background: The current study aimed to assess the prevalence of inappropriate prescribing (IP) for hospitalized elderly patients at Al Shifa Hospital, Gaza, Palestine. Methods: This study was a retrospective cross-sectional study. A total of 2385 prescribed drugs for 380 elderly inpatients in internal, cardiology, and respiratory departments were screened for IP. Four criteria were used to detect IP using chart review method; Drug-drug interactions (DDIs), drug contra- indications (CI), duplication of therapy and Beers' criteria 2012. Results: The results showed that 44.2% of patients had at least one IP. Around 33.2% of the patients had DDIs, 19.2% had IP according to Beers' criteria and 1.1% had drug CI. There was no duplication of therapy. A total of 323 IP instances were detected. Of them, 74% for DDIs and 24.8% for Beers' criteria. The prevalence of overall IP was significantly influenced by age (p- value=0.024), polypharmacy (p-value<0.001), degree of morbidity (p- value<0.001), and departments (p-value=0.018). The prevalence of DDIs was influenced by polypharmacy (p-value<0.001), degree of morbidity (p- value=0.001), and departments (p-value=0.005). Finally, the prevalence of IP according to Beers' criteria was significantly influenced by departments with the highest in the cardiology department (29.7%) (P-value=0.007). Conclusions: Although the overall IP was common, it was not far higher than that reported worldwide. The majority of IP was DDIs. Age, polypharmacy, degree of morbidity and departments influenced the occurrence of IP. Keywords: Beers' criteria, Contraindications, Drug-drug interactions, Elderly, Hospital, Inappropriate prescribing DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20164091 Department of Pharmacology, Faculty of Pharmacy, Al-Azhar University, Gaza, Palestine Received: 11 September 2016 Accepted: 12 October 2016 *Correspondence to: Dr. Lina K. Massoud, Email: massoudlina2009@ hotmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open- access article distributed under the terms of the Creative Commons Attribution Non- Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.