الفهرس 
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Abstract
Elderly people are more vulnerable to the adverse medication outcomes due to the age related changes in drug pharmacokinetics, pharmacodynamics, and complex drug regimens.
The risk of polypharmacy, complex medication regimens and inappropriate prescribing of medications rise especially with the increased prevalence of co-morbidities and symptoms in elderly persons.
Appropriate prescribing of medications in elderly especially with advancing age is a major clinical and economic issue. Therefore, health care and appropriate use of medications with advancing age is one of the major challenges facing health care systems.
Potentially inappropriate prescriptions (PIP) are defined by the presence of a risk of prescribed drugs that overweighs their benefit. Especially, when there are safer alternatives and include misuse of medications, prescription of drugs with significant drug–drug or drug–disease interactions and the negligence of beneficial medications.
Nursing home residents are particularly more vulnerable to potentially inappropriate prescribing (PIP) as they are more fragile, receive therapy from multiple health care workers and are often prescribed a high number of medications.
The aim of our study was to assess the prevalence of potentially inappropriate prescription among a sample of Egyptian elderly patients in geriatric homes.
The study was performed on a sample of 120 elderly males and females living in geriatric homes in Cairo with more than 3 months of geriatric home stay.
They were subjected to comprehensive geriatric assessment (CGA) including personal history, past medical history, cognitive assessment using the MMSE, psychological assessment using the GDS, nutritional assessment using MNA, functional assessment using the ADL and IADL, risk of fall using Timed Up and Go test and assessment of potentially inappropriate prescription using Beers criteria 2012 and STOPP criteria 2008.
The prevalence of potentially inappropriate prescription (PIP) among the studied sample in geriatric homes in Egypt using beers criteria was 24.2% and was 22.5% by using STOPP criteria.
In addition, in the current study 49 elderly presenting (40.8%) of the studied sample took polypharmacy (using five or more drugs).
Potentially inappropriate prescription was found to be statistically significant with advanced age using Beers criteria, as about 65.5% of those with potential inappropriate prescription were above 70 years, while only 36.3% of those with no potentially inappropriate prescription were above 70 years.
The most common potentially inappropriate prescription (PIP) to be avoided using Beers criteria 2012 was oral NSAIDs.
We found that (65.5%) of the studied elderly participants who had osteoarthritis (n= 19) are likely to use one or more potentially inappropriate prescription by Beers criteria, there is highly significant relation between using PIP in beers criteria and osteoarthritis.
The study showed that the medications which avoided in the elderly with risk of falls as anticonvulsants (carbamazabine) was found in 2 cases (1.7%), while Medications avoided in renal impairment as (Oral NSAIDs was found in 1 case ( 0.8%) also Medications avoided in chronic constipation as (antipsychotic drugs) was found in 1 case (0.8%), according to Beers criteria 2012.
The current study showed that medications used with caution according to Beers criteria were aspocid, which has been used in 4 elderly participants more than 80 years old presenting (3.3%) of the studied cases. Vasodilators (Nitrates) have been used in 4 elderly participants which may increase risk of syncope presenting (3.3%) of the studied cases, while drugs that May exacerbate or cause SIADH or hyponatremia as carbamazepine was taken by 1 elderly presenting (0.8%) of the studied cases.
The most common potentially inappropriate prescription (PIP) using STOPP criteria was using long term oral NSAIDs (more than 3 months) for mild joint osteoarthritis.
Polypharmacy, chronic medical diseases and common geriatric conditions were of no statistical significance with potentially inappropriate prescription (PIP) using Beers and STOPP criteria.
Geriatric domains (cognition, psychological, nutritional, functional, and fall risk) were of no statistical significance with potentially inappropriate prescription (PIP) using Beers and STOPP criteria.
Potentially inappropriate prescription (PIP) using Beers criteria was found to be statistically significant with uncontrolled blood pressure and polypharmacy found to be associated with uncontrolled blood pressure also.
Potentially inappropriate prescription (PIP) using STOPP criteria was found to be statistically significant with hearing and visual impairment.