Prescribing Patterns and Inappropriate Use of Medications in Elderly Outpatients in a Tertiary Hospital in Nigeria

Purpose: To determine the prescribing patterns and occurrence of potentially inappropriate medications (PIM) among elderly outpatients visiting a tertiary hospital in Nigeria. Methods: A retrospective study was carried out among elderly subjects (age >= 60 years) who were issued prescriptions in the outpatients department of Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Nigeria. Data were obtained on demographics, prescribing indicators and potentially inappropriate medications using Beer's criteria. Results: Of the 1000 prescriptions consecutively selected, 546 (54.6 %) were for women and 454 were for men, giving a female to male ratio of 1:0.83. The mean age of the subjects was 68.9 +/- 7.3 years. Analgesics (756, 75.6 %) were the most commonly prescribed medicines. Prescription of antimalarials was low 127 (12.7 %). The total number of medications prescribed was 3979 while the mean number of medications per encounter was 3.9. The medications prescribed by generic name were 1945 (48.9 %). Encounters with antibiotic and injection prescriptions were 203 (23 %) and 8 (0.8 %), respectively, while the proportion of medications prescribed that were on Nigeria's essential medicines list or formulary was 95.4 %. Four hundred and fifty six (45.6 %) prescriptions had one or more potentially inappropriate medicine. Medicines with high and low severity for potentially adverse events occurred in 82.7 % and 17.3 % of the cases, respectively. Conclusion: Medication prescribing among the elderly is still suboptimal. Appropriate interventions are required from all stakeholders.