Analysis of prescription pattern of antihypertensive medication and adherence to Beers criteria in geriatric department of a tertiary care hospital in Mysuru

C. A. Priyanka, Jayanthi M. K., Pratibha Periera, Ranjith Raj


Background: The objective of the present study was to evaluate the prescription pattern of anti-hypertensive drugs and adherence to Beers’ criteria in geriatric department of JSS Hospital, Mysuru.

Methods: An observational, prospective, cross-sectional study was carried out in geriatric department. The basic demographic information and prescriptions of geriatric patients were studied. Descriptive analysis was used to present the results, prescriptions were analysed and checked for adherence to Beers’ criteria.

Results: Out of 485 patients, 82.68% received monotherapy, 15.87% received 2-drug combination therapy and 1.4% received 3-drug combination therapy. Among patients receiving monotherapy, angiotensin receptor blockers (49.06%) was the commonest antihypertensive class of drug prescribed. Telmisartan (38.96%) was the commonest drug prescribed. Among 2-drug combination therapy angiotensin converting enzyme inhibitor and Calcium channel blockers were combined commonly. In 3-drug combination therapy angiotensin converting enzyme inhibitor, beta blockers and diuretics were combined commonly. 99.3% of prescriptions were adhered to 2015 American Geriatrics Society Beers criteria.

Conclusions: Almost 82% of the patients were treated with monotherapy. The trends in prescribing of anti-hypertensives were in favor of conventional ones such as Angiotensin receptor blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, diuretics, beta blockers and centrally acting alpha agonists. 99.3% of prescriptions were in accordance with the American Geriatrics Society 2015 Updated Beers criteria.


Hypertension, Anti-hypertensive treatment, Prescription pattern, Adherence, Geriatrics, Beers criteria

Full Text:



WHO health statistics, 2012. Available at: /2012/en/. Accessed on 17 September 2019.

Jain S, Upadhyaya P, Goyal J, Abhijit K, Jain P, Seth V, et al. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspectives Clin Res. 2015;6(2):86-90.

Joseph TH, Kenneth ES, Christine MR, Morris W. Suboptimal prescribing in older inpatient and outpatient. JAGS. 2001;49(2):200-9.

Christine MC. American Geriatrics Society updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012;60(4):616-31.

Routledge PA, O’Mahony MS, Woodhouse KW. Adverse drug reactions in elderly patients. Br J Clin Pharmacol. 2004;57(2):121-6.

Beers criteria. Available at: https://en.wikipedia.Org /wiki/Beers_Criteria. Accessed on 21 November 2019.

By the American Geriatrics Society 2015 Beers criteria update expert panel. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. JAGS. 2015.

Konwar M, Paul PK, Das S. Prescribing pattern of antihypertensive drugs in essential hypertension in medicine out patients department in a tertiary care hospital. Asian J Pharm Clin Res. 2014;7(2):142-4.

Egan BM, Bandyopadhyay D, Shaftman SR, Wagner CS, Zhao Y, Yu-Isenberg KS. Initial Monotherapy and Combination Therapy and Hypertension Control the First Year. Hypertension. 2012;59(6):1124-31.

Sharma AK, Dahiya N, Kairi JK, Bharati SM. Prescription patterns of antihypertensive drugs in a tertiary care hospital in India. Int J Basic Clin Pharmacol. 2015;4(1):55-9.

Ruilope LM. Telmisartan for the management of patients at high cardiovascular risk. Curr Med Res Opin. 2011;27(8):1673-82.

Mitka M. CCB/ACE Inhibitor Dual Therapy for Hypertension Lowers Cardiovascular Risk. JAMA. 2008;299(19):2263–4.

Sikidar P, Chakravarty P, Purkayastha A, Tigga R. A study on prescribing pattern of antihypertensives in adult patients attending in a tertiary care hospital of Assam, India. Int J Basic Clin Pharmacol. 2016;5(3):975-8.

Gorostidi M, de la Sierra A. Combination therapies for hypertension–why we need to look beyond RAS blockers. Expert Review Clin Pharmacol. 2018;11(9):841-53.

Aparasu RR, Fliginger SE. Inappropriate medication prescribing for the elderly by office-based physicians. Ann Pharmacother.1997;31:823-9.

Willcox SM, Himmelsten DU, Woolhandler S. Inappropriate drug prescribing for the community-dwelling elderly. JAMA. 1994;272:292-6.

Stuck AE, Beers MH, Steiner A, Aronow HU, Rubenstein LZ, Beck JC. Inappropriate medication use in community-residing older persons. Arch Intern Med. 1994;154:2195-200.