Prescribing audit in adult inpatient units using the Beer’s criteria

Aims – Polypharmacy, the prescribing of too many medications, is prevalent within the older adult patient group and is a well-known factor in increased costs of healthcare, adverse drug reactions, drug interactions, medication non-adherence, cognitive impairment, falls and incontinence. Various studies suggest the prevalence of polypharmacy within the inpatient setting is between 21% and 66%. The Beer’s criteria are an extensively researched compendium of medications that are deemed to be potentially inappropriate for older adults. Methods – These criteria were used as the standard for which the prescriptions within two older adult psychiatric inpatient wards were compared. Results – Across two inpatient older adult psychiatric wards the overall number of potentially inappropriate prescriptions was 77 out of 309 (24.9%). Conclusions – This figure is in line with current research but it is not clear whether this is can be considered acceptable. This audit highlights some of the shortcomings of the Beer’s criteria. Whilst the criteria are only a guide, they do not appear to take into account this unique patient setting when defining potentially inappropriate medications. The use of hypnotics and antipsychotics to aid sleep and as part of a rapid tranquilisation procedure is vital in managing patients in a mental health unit.