Prescription of potentially inappropriate medications in older adults: data from a dental institution

Objectives: The objectives of this study were to determine the types and frequency of potentially inappropriate medications (PIMs) prescribed to geriatric patients while considering the patients’ age groups and their American Society of Anesthesiologists (ASA) physical status. Study Design: We performed a 5-year retrospective chart review of patients aged 65 years and above who were seen in a dental institution. Patients’ medical history, PIM prescriptions, and prescribers’ specialty and professional status were analyzed. Results: Out of 10,675 geriatric patients identified, 6.2% (n = 662) received PIM prescriptions. Of those, 77% received one PIM whereas the others (23%) received anywhere between 2 and 6; the majority (73.7%) of these 662 patients fell within an ASA III physical status. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most prescribed PIM (provided to 60.1% of subjects) followed by opioids (provided to 32.5% of subjects). Both NSAIDs and opioids were largely provided by providers in oral and maxillofacial surgery followed by those in restorative dentistry and periodontics. Benzodiazepines were mostly prescribed by endodontics providers, whereas tricyclic antidepressants, muscle relaxants, and anticonvulsants were mostly prescribed by oral medicine providers. Residents prescribed opioids at similar rates to the faculty (P = .78) but exceeded the faculty in prescribing benzodiazepines (P < .001). Conclusion: PIMs were prescribed at low percentages to geriatric patients; however, most prescriptions were provided to patients classified with ASA III status. Further efforts are indicated, at institutional and national levels, to monitor/limit PIMs provided to geriatric population.