Background. Prescribing for older patients is a well-recognised problem, and inappropriate items are prescribed frequently. Several tools
and criteria are available to promote rational prescribing in older patients.
Objective. To determine the prevalence of potentially inappropriate prescriptions (PIPs) in older South African patients.
Methods. A retrospective drug utilisation review was conducted using medicine claims data over a 1-year period. Patients aged ≥65 years with at least
one paid claim for any medicine item during this period were included. The prevalence of PIPs was identified by applying the 2012-Beers criteria list.
Results. A total of 103 420 patients, mean age 74.0 years (standard deviation 6.7), 57.1% female, were included in the analysis. The number
of PIPs identified was 562 852 in 71 206 patients (68.9%). The most common medicines inappropriately prescribed were oestrogen (oral
and patch formulations only) (12.4%), meloxicam (7.3%), amitriptyline and combinations thereof (6.5%), diclofenac (6.4%), ibuprofen
(6.1%), alprazolam (5.3%), meprobamate and combinations thereof (5.0%), sliding-scale insulin (3.3%), amiodarone (3.1%) and doxazosin
(2.6%). Medicines were inappropriately prescribed to women statistically significantly more often than to men (1.9:1; p<0.001), although
this difference was not of practical significance (Cramér’s V=0.06).
Conclusions. Medicine use in older patients must be appropriate and evaluated regularly. According to explicit criteria, PIPs were found
to be common in older patients registered on the database. Monitoring of PIPs may increase the quality of prescribing, but explicit criteria
cannot substitute for clinical judgement based on the individual patient.