Identification of Potentially Inappropriate Medications (PIMs) Based on Beers 2023 in Geriatric Type-2 Diabetes Outpatients

Abstract

Geriatric patients with type-2 diabetes mellitus are particularly vulnerable to the use of potentially inappropriate medication (PIM) due to the complexity of their therapeutic regimens, age-related physiological changes, and the presence of multiple comorbidities. The pharmacological management of diabetes often involves medications that carry a higher risk of adverse effects or drug interactions in older adults, contributing to polypharmacy and increasing the likelihood of PIMs. The Beers Criteria is a widely used tool to identify medications that may be inappropriate for the elderly. This study aimed to look at the types of medications used, how often potentially inappropriate medications (PIMs) were prescribed, and how patient characteristics related to PIM prescriptions among older outpatients with type-2 diabetes at Panjatan 1 Primary Health Centre in Gunungkidul Regency, Special Region of Yogyakarta, Indonesia. This was a descriptive observational study using retrospective data from patient prescriptions that met the inclusion and exclusion criteria during June–July 2024. The data were analysed using descriptive statistics and the Spearman correlation test to assess the relationship between medication profiles and PIM occurrences. The results showed a PIM prevalence of 85.4% (35 out of 41 patients), with the most common PIM category being category 1 (89.8%). The most frequently identified PIM was glimepiride (67.4%). A strong correlation was found between the number of medications prescribed and the occurrence of PIMs (p < 0.001, r = 0.711) and a weak correlation with fasting blood glucose levels (p = 0.040, r = -0.265). The high incidence of PIMs among geriatric patients with type-2 diabetes mellitus highlights the need for optimised pharmacotherapy to minimise adverse effects. Regular evaluation of prescribing practices using the Beers Criteria can enhance medication safety in this population.