Drug utilization pattern in geriatric inpatients of medicine department in a Tertiary Care Teaching Hospital

Swapna R. Nayaka, B. Rajeshwari, T. V. Venkatadri


Background: The objective of present study was to assess the drug utilization pattern among the geriatric patients.

Methods: Totally, 150 prescriptions of patients’ ≥65 years admitted in the medicine inpatient department of MVJ Medical College and Research Hospital, Hoskote were noted from September 2013 to March 2014 and demographic profile, drug utilization pattern, commonly used drugs as per anatomical therapeutic chemical classification (ATC) and WHO core indicators were assessed after taking informed consent from the patients.

Results: Out of 150 patients, average age of geriatric patients was 66.83 years with female preponderance (59%). Maximum number of patients were having respiratory disorders (66.67%) followed by diabetes mellitus (35.3%), and cardiovascular diseases (32.67%). 76% patients had co-morbid diseases like diabetes mellitus (n=53), hypertension (n=49), and chronic obstructive pulmonary disease (n=41). A total of 849 drug formulations, containing 1050 active ingredients, were prescribed with average number of 7 (1050/150) drugs per prescription. Only 70 formulations were prescribed by their generic names, which is less than that prescribed by their brand names 779 and total of 146 (17.19%) drugs were prescribed as fixed dose combinations. Only 45.47% drugs were according to WHO Essential Medicines List. Drugs acting on respiratory system (n=189) were the most commonly used drugs in our study followed by drugs acting on the gastrointestinal system (n=130), antimicrobials (n=113), cardiovascular system (n=112), endocrine (n=83), and nutritional supplements (n=72). Polypharmacy was prevalent in 62% and about 22.67% of patients received <5 drugs. Pantoprazole was most frequently prescribed drug followed by aspirin 75 mg, adrenergic, and anticholinergic bronchodilators.

Conclusion: Thus, irrational prescribing and polypharmacy were prevalent among elderly. Drug utilization data can help in assessing the quality of care given to the geriatric patients and promote rational use of medicines.


Drug utilization pattern, Anatomical therapeutic chemical code, WHO Essential medicine list

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World Health Organization. Introduction to Drug Utilization Research. Geneva: World Health Organization; 2003.

Helena G. Drug utilization studies. Arq Med. 2008;22 (2-3):69-74.

Guaraldo L, Cano FG, Damasceno GS, Rozenfeld S. Inappropriate medication use among the elderly: a systematic review of administrative databases. BMC Geriatr. 2011;11:79.

Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA. 2002;287(3):337-44.

Barat I, Andreasen F, Damsgaard EM. The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol. 2000;56(6-7):501-9.

Straand J, Rokstad KS. Elderly patients in general practice: diagnoses, drugs and inappropriate prescriptions. A report from the Møre and Romsdal prescription study. Fam Pract. 1999;16(4):380-8.

Starner CI, Gray SL, Guay DR, Hajjar ER, Handler SM. Geriatrics. In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, editors. Pharmacotherapy A Pathophysiologic Approach. 7th Edition. New York: McGraw Hill; 2008: 57-66.

Fadare JO, Agboola SM, Opeke OA, Alabi RA. Prescription pattern and prevalence of potentially inappropriate medications among elderly patients in a Nigerian rural tertiary hospital. Ther Clin Risk Manag. 2013;6:115-20.

Gavilán Moral E, Morales Suárez-Varela MT, Hoyos Esteban JA, Pérez Suanes AM. Inappropriate multiple medication and prescribing of drugs immobile elderly patients living in the community. Aten Primaria. 2006;38:476-80.

Steinman MA, Landefeld CS, Rosenthal GE, Berthenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 2006;54(10):1516-23.

Eze UI, Olowu AO. Prescribing patterns and inappropriate use of medications in elderly outpatients in a tertiary care hospital in Nigeria. Trop J Pharm Res. 2011;10(1):19.

Momin TG, Pandya RN, Rana DA, Patel VJ. Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: a comparison between Beers 2003 and 2012 criteria. Indian J Pharmacol. 2013;45(6):603-7.

Tôrres Faggiani F, Schroeter G, Luz Pacheco S, Araújo De Souza AC, Werlang MC, Attílio De Carli G, et al. Profile of drug utilization in the elderly living in Porto Alegre, Brazil. Pharm Pract (Granada). 2007;5:179-84.

Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi CB. Drug utilization pattern and pharmacoeconomic analysis in geriatric medical in-patients of a tertiary care hospital of India. J Pharmacol Pharmacother. 2014;5(1):15-20.

Shah RB, Gajjar BM, Desai SV. Drug utilization pattern among geriatric patients assessed with the anatomical therapeutic chemical classification defined daily dose system in a rural tertiary care teaching hospital. Int J Nutr Pharmacol Neurol Dis. 2012;2(3):258-65.

Sharma N, Advani U, Kulshreshtha S, Parakh R, Bansal A, Sinha RR, et al. Screening of prescriptions in geriatric population in a tertiary care teaching hospital in north India. J Phytopharmacol. 2013;2(5):38-45.

Amit GS. Drug use evaluation study in a tertiary care corporate hospital with special reference to use of anti-niotics in ICU department. Int J Adv Pharm Biol Chem. 2013;2(1):179-89.

Braga TB, Pfaffenbach G, Weiss DP, Barros MB, Bergsten-Mendes G. Point prevalence of drug prescriptions for elderly and non-elderly inpatients in a teaching hospital. Sao Paulo Med J. 2004;122:48-52.

Desai SV. Essential drugs and rational drug therapy. Bull Soc Ration Ther. 2001;12:2-7.

Zaveri HG, Mansuri SM, Patel VJ. Use of potentially inappropriate medicines in elderly: a prospective study in medicine out-patient department of a tertiary care teaching hospital. Indian J Pharmacol. 2010;42(2):95-8.

Shewade DG, Pradhan SC. Auditing of prescriptions in government teaching hospital and four retail medical stores in Pondicherry. Indian J Pharmacol. 1998;30:408-10.

Zaveri H. Drug Use in Elderly: A Prospective Study in Medicine Outpatient Department of Tertiary Care Teaching Hospital [Dissertation]. Ahmedabad, Gujarat (India): The Gujarat University; 2008.

Satoshkar RS, Bhandarkar SD, Rege NN. Pharmacology and Pharmacotherpaeutics. 20th Edition. Mumbai: Popular Prakashan Private Limited.; 2007.

Patel VJ, Malhotra S, Gautam C. Drug use pattern of antihypertensive drugs in outdoor patients of a teaching hospital. Gujarat Med J. 2002;59:41-3.

WHO | WHO Model Lists of Essential Medicines. Available at: Accessed 31 January 2015.

National List of Essential Medicines - Central Drugs Standard. Available at: Accessed 31 January 2015.

Rathnakar UP, Uhllal SD, Sadanand S. Profile of drug utilization among elderly patients attending cardiology clinic in Mangalore. J Pharm Res. 2010;3(8):1835-7.