Assessment of the Appropriateness of Prescribing Medication Among Geriatric Patients Using Beers Criteria: A Cross-sectional Study in a Government Tertiary Care Hospital, Mandya.

Background: Aging is the universal and biological process, with increase in life expectancy and reduction in fertility rates contributing to steep rise in the elderly population. This demographic transition has great implications for healthcare systems, as geriatric population are more susceptible to chronic diseases, reduced body function and medication related complications. Potentially Inappropriate Medications (PIMs) are a significant concern among geriatric patients due to age-related pharmacokinetic and pharmacodynamic changes. The Beers criteria, developed by the American Geriatric Society (AGS), serves as an essential tool to identify and reduce inappropriate prescribing. 
Objective: The objective of this study is to assess the appropriateness of prescribing medication among the geriatric patients using 2023 AGS Beers Criteria and to identify factors associated with PIM use. 
Methodology: A cross-sectional study was conducted among 310 geriatric inpatients (≥65 years) admitted at General Medicine Department of government tertiary care hospital in Mandya for period of 6 months. Medication appropriateness was evaluated using the 2023 AGS Beers Criteria. Data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression to assess associations between PIM use and predictors such as age, gender, number of diagnoses, and polypharmacy. 
Results: Among 310 patients included in the study 50.6% were female and 49.4% were male patients. The mean age of the population was 73.4 ±7.27 years, with median age of 72 years. Out of 310 patients 122 patients were prescribed with at least one PIM, out of 2,129 total number of medications with an average of 6.87 drugs per patients, 5.73% drugs were found to be PIMs. The frequently prescribed PIMs were found to be Antihistamine drug Chlorpheniramine, rapid acting insulin, and aspirin accounting up to 33.2%, 16.5%, and 15.7% respectively. The most frequently prescribed PIM category was Category 1, accounting for 75.8% of PIMs. Polypharmacy showed a statistically significant association with PIM use (p < 0.001), while age group, gender, and number of diagnoses were not significantly associated. Binary logistic regression revealed that patients with polypharmacy had 12 times higher odds of receiving a PIM.
Conclusion: PIM use among geriatric inpatients was high, with polypharmacy being a significant predictor. Implementing regular medication reviews using Beers Criteria could improve prescribing quality and reduce adverse outcomes in this population. Educating and training healthcare professionals on geriatric pharmacotherapy, and involvement of clinical pharmacists on routine patient care is necessary.