Fernández, A., Gómez, F., Curcio, C.-L., Pineda, E., and de Souza, J.F., Prevalence and impact of potentially inappropriate medication on community-dwelling older adults, Biomedica, 2021, vol. 41, no. 1, pp. 111–122. https://doi.org/10.7705/biomedica.5787

Article  PubMed  Google Scholar 

World Bank Group, World Bank Open Data, Population Ages 65 and above, Total—Pakistan, World Bank Open Data, 2023. https://data.worldbank.org. Accessed February 12, 2025.

Kosirova, S., Urbankova, J., Klimas, J., and Foltanova, T., Assessment of potentially inappropriate medication use among geriatric outpatients in the Slovak Republic, BMC Geriatr., 2023, vol. 23, no. 1, p. 567. https://doi.org/10.1186/s12877-023-04260-y

Article  PubMed  PubMed Central  Google Scholar 

Srivastava, S.B., Polypharmacy, unintended consequences, and impact of lifestyle medicine, Am. J. Lifestyle Med., 2023, vol. 18, no. 1, pp. 54–57. https://doi.org/10.1177/15598276231207302

Article  PubMed  PubMed Central  Google Scholar 

Wastesson, J.W., Morin, L., Tan, E.C.K., and Johnell, K., An update on the clinical consequences of polypharmacy in older adults: A narrative review, Expert Opin. Drug Saf., 2018, vol. 17, no. 12, pp. 1185–1196. https://doi.org/10.1080/14740338.2018.1546841

Article  PubMed  Google Scholar 

Tian, F., Chen, Z., Zeng, Y., Feng, Q., and Chen, X., Prevalence of use of potentially inappropriate medications among older adults worldwide, JAMA Network Open, 2023, vol. 6, no. 8, p. e2326910. https://doi.org/10.1001/jamanetworkopen.2023.26910

Article  PubMed  PubMed Central  Google Scholar 

By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel, American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults, J. Am. Geriatr. Soc., 2023, vol. 71, no. 7, pp. 2052–2081. https://doi.org/10.1111/jgs.18372

Chang, T.I., Park, H., Kim, D.W., Jeon, E.K., Rhee, C.M., Kalantar-Zadeh, K., Kang, E.W., Kang, S.-W., and Han, S.H., Polypharmacy, hospitalization, and mortality risk: A nationwide cohort study, Sci. Rep., 2020, vol. 10, no. 1, p. 18964. https://doi.org/10.1038/s41598-020-75888-8

Article  CAS  PubMed  PubMed Central  Google Scholar 

Klarin, I., Wimo, A., and Fastbom, J., The association of inappropriate drug use with hospitalisation and mortality: A population-based study of the very old, Drugs Aging, 2005, vol. 22, no. 1, pp. 69–82. https://doi.org/10.2165/00002512-200522010-00005

Article  PubMed  Google Scholar 

Kim, S., Lee, H., Park, J., Kang, J., Rahmati, M., Rhee, S.Y., and Yon, D.K., Global and regional prevalence of polypharmacy and related factors, 1997–2022: An umbrella review, Arch. Gerontol. Geriatr., 2024, vol. 124, p. 105465. https://doi.org/10.1016/j.archger.2024.105465

Article  PubMed  Google Scholar 

Bhagavathula, A.S., Vidyasagar, K., Chhabra, M., Rashid, M., Sharma, R., Bandari, D.K., and Fialova, D., Prevalence of polypharmacy, hyperpolypharmacy and potentially inappropriate medication use in older adults in India: A systematic review and meta-analysis, Front. Pharmacol., 2021, vol. 12, p. 685518. https://doi.org/10.3389/fphar.2021.685518

Article  PubMed  PubMed Central  Google Scholar 

Slabaugh, S.L., Maio, V., Templin, M., and Abouzaid, S., Prevalence and risk of polypharmacy among the elderly in an outpatient setting: A retrospective cohort study in the Emilia-Romagna Region, Italy, Drugs Aging, 2010, vol. 27, no. 12, pp. 1019–1028. https://doi.org/10.2165/11584990-000000000-00000

Article  PubMed  Google Scholar 

Sangaleti, C.T., Lentsck, M.H., da Silva, D.C., Machado, A., Trincaus, M.R., Vieira, M.C.U., Pelazza, B.B., and Colombo, F.M.C., Polypharmacy, potentially inappropriate medications and associated factors among older adults with hypertension in primary care, Rev. Bras. Enferm., 2023, vol. 76, suppl. 2, p. e20220785. https://doi.org/10.1590/0034-7167-2022-0785pt

Article  PubMed Central  Google Scholar 

Nafrialdi, N., Jamal, A.K., Hardi, H., and Widyastuti, R., Polypharmacy and the risk of adverse drug reactions in the elderly at a tertiary referral hospital in Indonesia: Assessing the applicability of the GerontoNet Score, Acta Med. Indones., 2025, vol. 57, no. 1, pp. 74–80.

PubMed  Google Scholar 

Thapa, R.B., Dahal, P., Karki, S., and Mainali, U.K., Exploration of drug therapy related problems in a general medicine ward of a tertiary care hospital of Eastern Nepal, Explor. Res. Clin. Soc. Pharm., 2024, vol. 16, p. 100528. https://doi.org/10.1016/j.rcsop.2024.100528

Article  PubMed  PubMed Central  Google Scholar 

Zhu, X., Zhang, F., Zhao, Y., Zhang, W., Zhang, Y., and Wang, J., Evaluation of potentially inappropriate medications for the elderly according to Beers, STOPP, START, and Chinese criteria, Front. Pharmacol., 2023, vol. 14, p. 1265463. https://doi.org/10.3389/fphar.2023.1265463

Article  CAS  PubMed  Google Scholar 

Mangi, A.A., Hammad, M.A., Khan, H., Arain, S.P., Shahzad, M.A., Dar, E., Alam, A., and Hassanein, A.H.A., Evaluation of the geriatric patients prescription for inappropriate medications frequency at Larkana Sindh Hospital in Pakistan, Clin. Epidemiol. Global Health, 2020, vol. 8, no. 4, pp. 1390–1394. https://doi.org/10.1016/j.cegh.2020.06.001

Article  Google Scholar 

Mazhar, F., Akram, S., Malhi, S.M., and Haider, N., A prevalence study of potentially inappropriate medications use in hospitalized Pakistani elderly, Aging Clin. Exp. Res., 2018, vol. 30, no. 1, pp. 53–60. https://doi.org/10.1007/s40520-017-0742-7

Article  PubMed  Google Scholar 

Sarwar, M.R., Dar, A.-R., Mahar, S.Y., Riaz, T., Danish, U., and Iftikhar, S., Assessment of prescribing potentially inappropriate medications listed in Beers criteria and its association with the unplanned hospitalization: A cross-sectional study in Lahore, Pakistan, Clin. Interv. Aging, 2018, vol. 13, pp. 1485–1495. https://doi.org/10.2147/CIA.S173942

Article  PubMed  PubMed Central  Google Scholar 

Giri, R., Shrestha, R., Rai, A., Kandel, G., Gauchan, P., and Thapa, P., Potentially inappropriate medications and drug-drug interactions in geriatrics cardiac patients visiting to tertiary care central hospital of Nepal, Aging Med. (Milton), 2025, vol. 8, no. 4, pp. 303–311. https://doi.org/10.1002/agm2.70034

Article  PubMed  Google Scholar 

Hajian-Tilaki, K., Sample size estimation in epidemiologic studies, Caspian J. Intern. Med., 2011, vol. 2, no. 4, pp. 289–298. www.ncbi.nlm.nih.gov/pmc/articles/PMC3895825/.

PubMed  PubMed Central  Google Scholar 

Danisha, P., Dilip, C., Mohan, P.L., Shinu, C., Parambil, J.C., and Sajid, M., Identification and evaluation of Potentially Inappropriate Medications (PIMs) in hospitalized geriatric patients using Beers criteria, J. Basic Clin. Physiol. Pharmacol., 2015, vol. 26, no. 4, pp. 403–410. https://doi.org/10.1515/jbcpp-2014-0054

Article  PubMed  Google Scholar 

Karki, S., Thapa, R.B., and Shrestha, R., Exploring potentially inappropriate medication use on elderly patients in a general medicine ward using 2023 AGS Beers criteria, Aging Med., 2025, vol. 8, no. 3, pp. 238–248. https://doi.org/10.1002/agm2.70025

Article  Google Scholar 

Endres, H.G., Kaufmann-Kolle, P., Steeb, V., Bauer, E., Böttner, C., and Thürmann, P., Association between Potentially Inappropriate Medication (PIM) use and risk of hospitalization in older adults: An observational study based on routine data comparing PIM use with use of PIM alternatives, PLoS One, 2016, vol. 11, no. 2, p. e0146811. https://doi.org/10.1371/journal.pone.0146811

Article  CAS  PubMed  PubMed Central  Google Scholar 

Jaynes, M. and Kumar, A.B., The risks of long-term use of proton pump inhibitors: A critical review, Ther. Adv. Drug Safety, 2019, vol. 10, p. 2042098618809927. https://doi.org/10.1177/2042098618809927

Article  Google Scholar 

Maideen, N.M.P., Adverse effects associated with long-term use of proton pump inhibitors, Chonnam Med. J., 2023, vol. 59, no. 2, pp. 115–127. https://doi.org/10.4068/cmj.2023.59.2.115

Article  CAS  PubMed  PubMed Central  Google Scholar 

Robert-Ebadi, H., Le Gal, G., and Righini, M., Use of anticoagulants in elderly patients: Practical recommendations, Clin. Interv. Aging, 2009, vol. 4, pp. 165–177. https://doi.org/10.2147/cia.s4308

Article  CAS  PubMed  PubMed Central  Google Scholar 

Rodriguez-Cillero, C., Menu, D., d’Athis, P., Perrin, S., Dipanda, M., Asgassou, S., Guepet, H., Mazen, E., Manckoundia, P., and Putot, A., Potentially inappropriate use of furosemide in a very elderly population: An observational study, Int. J. Clin. Pract., 2017, vol. 71, no. 8. https://doi.org/10.1111/ijcp.12975

Rodríguez-Molinero, A., Miñarro, A., Narvaiza, L., Gálvez-Barrón, C., Gonzalo León, N., Valldosera, E., De Mingo, E., Macho, O., Aivar, D., Pinzón, E., Alba, A., Passarelli, J., Stasi, N., Collado, I., and Banegas, J.R., Mortality in elderly patients taking furosemide: Prospective cohorts study, Int. J. Hypertens., 2022, vol. 2022, p. 4708259. https://doi.org/10.1155/2022/4708259

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hwang, K., Moore, K.J., Chong, T.W.H., Williams, S., and Batchelor, F., Improving Clinical Practice Guidelines for older people: Considerations and recommendations for more inclusive and ageing-relevant guidelines, Lancet Healthy Longev., 2022, vol. 3, no. 5, pp. e316–e317. https://doi.org/10.1016/S2666-7568(22)00074-5

Article  PubMed  Google Scholar 

Sönnichsen, A., Trampisch, U.S., Rieckert, A., Piccoliori, G., Vögele, A., Flamm, M., Johansson, T., Esmail, A., Reeves, D., Löffler, C., Höck, J., Klaassen-Mielke, R., Trampisch, H.J., and Kunnamo, I., Polypharmacy in Chronic Diseases-Reduction of Inappropriate Medication and Adverse Drug Events in Older Populations by Electronic Decision Support (PRIMA-eDS): Study protocol for a randomized controlled trial, Trials, 2016, vol. 17, p. 57. https://doi.org/10.1186/s13063-016-1177-8