Identification of Potentially Inappropriate Medications (PIMs) by Beers Criteria in Geriatric Patients at RSA UGM Yogyakarta

Sundas Ejaz Ejaz(1), Fita Rahmawati(2*), Zullies Ikawati(3)

(1) Universitas Gadjah Mada
(2) Universitas Gadjah Mada
(3) Universitas Gadjah Mada
(*) Corresponding Author


PIM (Potentially Inappropriate Medications) is one of the primary concerns leading to adverse health outcomes, higher risk of Adverse Drug Reactions (ADEs), decreased therapeutic effects, hospitalization, and unnecessary healthcare costs in the geriatric population. Therefore, this study aimed to determine the prevalence PIMs, and to identify the most common PIMs prescribed to hospitalized geriatric patients admitted at RSA UGM, Yogyakarta based on Beers Criteria 2019. A cross sectional study using electronic medical records data was conducted in geriatric patients aged >60 years admitted to the internal medicine ward. PIMs were identified using the Beers criteria 2019. Descriptive statistics were used to describe patient and drug characteristics. Total 70 geriatric patients met the inclusion criteria. The results revealed that the geriatric patients who received PIM were male (65.71%), in the age group of 60-65 years (51.42%), had comorbidities and polypharmacy between 5-9 (48.5%) and 61.42% respectively. The overall prevalence of PIMs was 77.1%, followed by prevalence of PIMs to be used with caution (70 percent), and PIMs avoided in geriatric patients (62.8%). The most commonly prescribed PIMs were diuretics (48.5%) and sliding scale insulin (24.2%). A high prevalence of PIMs was found in this study, which is alarming. The prescription of PIMs can be overcome by encouraging strategies, such as close monitoring of the patient's condition for potential ADEs, gender and pharmacokinetic/pharmacodynamic consideration when prescribing drug therapy to geriatric patients.


PIM, geriatric patients, Beers Criteria 2019, RSA UGM

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American Geriatrics Society. (2019). American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Journal of the American Geriatrics Society; 67; 1-21. doi: 10.1111/jgs.15767.

Ahmed, A., Faris, A., Jamal, K., Rafeea, B., Aljawamis, D., & Al, J. (2021). Potentially inappropriate medications in older adults according to Beers criteria 2019 : Prevalence and risk factors. Int J Clin Pract., March, 1–8.

Abdelwahed, A. A., El-Dahiyat, F., Aljawamis, D., Al Ajimi, J., & Bin Rafeea, K. J. (2021). Potentially inappropriate medications in older adults according to Beers criteria 2019: Prevalence and risk factors. International journal of clinical practice, 75(11), e14715.

Alshammari, H., Al-Saeed, E., Ahmed, Z., & Aslanpour, Z. (2021). Reviewing Potentially Inappropriate Medication in Hospitalized Patients Over 65 Using Explicit Criteria: A Systematic Literature Review. Drug, healthcare and patient safety, 13, 183–210.

Al-Azayzih, A., Alamoori, R., & Altawalbeh, S. M. (2019). Potentially inappropriate medications prescribing according to Beers criteria among geriatric outpatients in Jordan: a cross sectional study. Pharmacy practice, 17(2), 1439.

Butler, J. V., McAvoy, H., McEnroy, D., & Mulkerrin, E. C. (2002). Spironolactone therapy in older patients--the impact of renal dysfunction. Archives of gerontology and geriatrics, 35(1), 45–49.

Bhardwaj, A. (2021). Prevalence of Polypharmacy and Potentially Inappropriate Medications in Elderly Patients : Cross Sectional Study Based on Updated Beer ’ s Criteria 2019. Journal of Clinical Pharmacology and Therapeutics, 2, 2017–2022.

Cardone, K. E., Bacchus, S., Assimon, M. M., Pai, A. B., & Manley, H. J. (2010). Medication-related problems in CKD. Advances in chronic kidney disease, 17(5), 404–412.

Garg, D. C., Baltodano, N., Jallad, N. S., Perez, G., Oster, J. R., Eshelman, F. N., & Weidler, D. J. (1986). Pharmacokinetics of ranitidine in patients with renal failure. Journal of clinical pharmacology, 26(4), 286–291.

Hyttinen, V., Jyrkkä, J., Saastamoinen, L. K., Vartiainen, A. K., & Valtonen, H. (2019). Patient- and health care-related factors associated with initiation of potentially inappropriate medication in community-dwelling older persons. Basic & clinical pharmacology & toxicology, 124(1), 74–83.

Kurczewska-Michalak, M., Lewek, P., Jankowska-Polańska, B., Giardini, A., Granata, N., Maffoni, M., Costa, E., Midão, L., & Kardas, P. (2021). Polypharmacy Management in the Older Adults: A Scoping Review of Available Interventions. Frontiers in pharmacology, 12, 734045.

Khader, Hasoun, L. Z., Alsayed, A., & Abu-Samak, M. (2021). Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria. Pharmacia, 68 (4), 789–795.

Liu, D., Ahmet, A., Ward, L., Krishnamoorthy, P., Mandelcorn, E. D., Leigh, R., Brown, J. P., Cohen, A., & Kim, H. (2013). A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 9(1), 30.

Lim, Y. J., Kim, H. Y., Choi, J., Lee, J. S., Ahn, A. L., Oh, E. J., Cho, D. Y., & Kweon, H. J. (2016). Potentially Inappropriate Medications by Beers Criteria in Older Outpatients: Prevalence and Risk Factors. Korean journal of family medicine, 37(6), 329–333.

Lewek, P., Jankowska-pola, B., Giardini, A., & Granata, N. (2021). Polypharmacy Management in the Older Adults : A Scoping Review of Available Interventions. Front. Pharmacol, 12(November), 1–15.

Nothelle, S. K., Sharma, R., Oakes, A., Jackson, M., & Segal, J. B. (2019). Factors associated with potentially inappropriate medication use in community-dwelling older adults in the United States: a systematic review. The International journal of pharmacy practice, 27(5), 408–423.

Queale, W. S., Seidler, A. J., & Brancati, F. L. (1997). Glycemic control and sliding scale insulin use in medical inpatients with diabetes mellitus. Archives of internal medicine, 157(5), 545–552.

Rawle, M. J., Richards, M., Davis, D., & Kuh, D. (2018). The prevalence and determinants of polypharmacy at age 69: A British birth cohort study. BMC Geriatrics, 18(1), 1–12.

Sharma, R., Bansal, P., Garg, R., Ranjan, R., Kumar, R., & Arora, M. (2020). Prevalence of potentially inappropriate medication and its correlates in geriatric hospitalized patients: A cross-sectional study based on Beers criteria. Journal of family & community medicine, 27(3), 200–207.

Scott, I. A., Hilmer, S. N., Reeve, E., Potter, K., Le Couteur, D., Rigby, D., Gnjidic, D., Del Mar, C. B., Roughead, E. E., Page, A., Jansen, J., & Martin, J. H. (2015). Reducing inappropriate polypharmacy: the process of deprescribing. JAMA internal medicine, 175(5), 827–834.

Thorell, K., Midlöv, P., Fastbom, J., & Halling, A. (2020). Use of potentially inappropriate medication and polypharmacy in older adults : a repeated cross-sectional study. BMC Geriatrics, 1–9.

Tao, L., Qu, X., Gao, H., Zhai, J., Zhang, Y., & Song, Y. (2021). Polypharmacy and potentially inappropriate medications among geriatric patients in the geriatric department at a single-center in China: A retrospective cross-sectional study. Medicine, 100(42), e27494.

Vatcharavongvan, P., Prasert, V.., Ploylearmsang, C., & Puttawanchai, V. (2021). Prevalence and Factors that Influence Potentially Inappropriate Medication Use among Thai Geriatric in Primary Care Settings. Canadian Geriatrics Journal, 24(4), 332–340.

World Health Organization. (2008). The world health report 2008: primary health care now more than ever.


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