All authors have agreed and read towards the posted version from the manuscript. Funding This extensive research received no external funding. Conflicts appealing The authors declare no conflict appealing. Footnotes Publishers Take note: MDPI remains neutral in regards to to jurisdictional promises in published maps and institutional affiliations.. Beers Requirements. Top five medications had been proton pump inhibitors (40.3%), non-steroidal anti-inflammatory medications (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is certainly high among old patients admitted to the hospital. More efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers. (%)(%)465 (54.8)260 (53.4)151 (55.1)54 (61.4)Gender(%)438 (51.6)248 (50.9)143 (52.2)47 (53.4)Beers Criteria Medication Identified684 (80.6%)387 (79.5%)226 (82.5%)71 (80.7%) Open in a separate window SD: standard deviation; = 0.94. There was no gender difference in adherence rate: 355 (81.1%) in males compared to 329 (80.0%) in females; = 0.568. Of the 34 PIMs identified as shown in Table 2, the top five prescribed medications or medication classes were proton pump inhibitors (PPIs) 741 (40.3%) prescriptions/orders, NSAIDs 187 (10.2%) prescriptions/orders, metoclopramide 171 (9.3%) prescriptions/orders, benzodiazepines 155 (8.4%) prescriptions/orders, and insulin 99 (5.4%) prescriptions/orders. Table 2 The most commonly encountered potentially inappropriate medication (PIMs) as per the 2019 Beers Criteria. thead th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ Medication /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ All Ages br / 849 (100%) /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 65C75 br / 487 (57.3%) /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 76C85 br / 274 (32.3%) /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 85 br / 88 (10.4%) /th /thead PPI741 (40.3%)435 (23.7%)251 (13.7%)55 (3.0%)NSAID187 (10.2%)121(6.6%)58 (3.2%)8 (0.4%)Metoclopramide171 (9.3%)100 (5.4%)55 (3.0%)16 (0.9%)Benzodiazepines155 (8.4%)85 (4.6%)57 (3.1%)13 (0.7%)Insulin99 (5.4%)67 (3.6%)25 (1.4%)7 (0.4%) Open in a separate window %: percentage; PPIs: proton pump inhibitors (omeprazole and pantoprazole); NSAIDs: nonsteroidal anti-inflammatory drugs (diclofenac and ibuprofen); Benzodiazepines: (diazepam and lorazepam); Insulin: insulin sliding scale. 4. Discussion 4.1. Summary The aim of our study was to identify the prevalence of PPIs among geriatric patients in an inpatient setting. We found that 80.6% of patients were prescribed at least one medication listed in the first class of the 2019 Beers Criteria. The top five drugs were PPIs (40.3%), NSAIDs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin sliding scale (5.4%). 4.2. Strengths and Limitations To the best of our knowledge, there are no published studies that evaluate the prevalence of PIMs in accordance with the updated version of the 2019 Beers Criteria in Saudi Arabia. This study identified the most common PIMs among older patients admitted to one of the largest tertiary hospitals in the western region of Saudi Arabia, with the intent to encourage prescribers to use the 2019 Beers Criteria. There were multiple limitations to the present research. First, the test was gathered from in-patients just retrospectively, which will not represent the geriatric people. Second, this scholarly research included the high grade of Beers Requirements solely, in which not absolutely all medicines listed for the reason that course were obtainable in our middle formulary. Additionally, the duration and indication of therapy from the prescribed medicines weren’t evaluated. 4.3. Evaluation with Existing Books Although several medications were taken off the brand new Beers Requirements, the prevalence of PIMs was higher in today’s research in comparison to that in two prior studies executed in Saudi Arabia that relied on old versions from the Beers Requirements. The first research discovered the prevalence to become 72.6% within a 135 population-based research conducted in Jeddah [13], whereas the other research reported a prevalence of 61% among 400 sufferers in Riyadh [16]. Many potential factors donate to the high prevalence of PIMs. Among the potential factors is that lots of prescribers comfortably depend on the same medicine for years and they’re dubious of substitutes. Prescribers must consider that many from the medicines aren’t universally appropriate but instead rely upon a sufferers circumstances [17]. Specifically, prescribers should become aware of the explanation of like the medicine in the Beers Requirements [17]. Moreover, wellness systems in a few institutions absence the privilege of flagging medicine shown in Beers Requirements for extra extreme care. Furthermore, elevated PIMs among geriatrics could be related to the usage of multiple medicines, known as polypharmacy also, which has elevated in geriatrics in the modern times [18,19]. Regarding to our outcomes, one of the most prescribed PIM was PPIs with an interest rate of 40 frequently.3%. This result was in keeping with a Chinese retrospective cross-sectional research that was executed in 2017 where the PPI make use of price was 41.9% [12]. Histamine-2 receptor antagonists could be used seeing that choice.Methods: The 2019 Beers Requirements were utilized to assess PIMs in every inpatient prescribed medicines concentrating on the high grade (i actually.e., medication/drug course to be prevented in old adults). hospital. Even more efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers. (%)(%)465 (54.8)260 (53.4)151 (55.1)54 (61.4)Gender(%)438 (51.6)248 (50.9)143 (52.2)47 (53.4)Beers Criteria Medication Identified684 (80.6%)387 (79.5%)226 (82.5%)71 (80.7%) Open in a separate window SD: standard deviation; = 0.94. There was no gender difference in adherence rate: 355 (81.1%) in males compared to 329 (80.0%) in females; = 0.568. Of the 34 PIMs identified as shown in Table 2, the top five prescribed medications or medication classes were proton pump inhibitors (PPIs) 741 (40.3%) prescriptions/orders, NSAIDs 187 (10.2%) prescriptions/orders, metoclopramide 171 (9.3%) prescriptions/orders, benzodiazepines 155 (8.4%) prescriptions/orders, and insulin 99 (5.4%) prescriptions/orders. Table 2 The most commonly encountered potentially improper medication (PIMs) as per the 2019 Beers Criteria. thead th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ Medication /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ All Ages br / 849 (100%) /th th align=”center” EX 527 (Selisistat) valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 65C75 br / 487 (57.3%) /th th align=”center” valign=”middle” style=”border-top:sound thin;border-bottom:solid thin” rowspan=”1″ EX 527 (Selisistat) colspan=”1″ 76C85 br / 274 (32.3%) /th th align=”center” valign=”middle” style=”border-top:sound thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 85 br / 88 (10.4%) /th /thead PPI741 (40.3%)435 (23.7%)251 (13.7%)55 (3.0%)NSAID187 (10.2%)121(6.6%)58 (3.2%)8 (0.4%)Metoclopramide171 (9.3%)100 (5.4%)55 (3.0%)16 (0.9%)Benzodiazepines155 (8.4%)85 (4.6%)57 (3.1%)13 (0.7%)Insulin99 (5.4%)67 (3.6%)25 (1.4%)7 (0.4%) Open in a separate windows %: percentage; PPIs: proton pump inhibitors (omeprazole and pantoprazole); NSAIDs: nonsteroidal anti-inflammatory drugs (diclofenac and ibuprofen); Benzodiazepines: (diazepam and lorazepam); Insulin: insulin sliding scale. 4. Conversation 4.1. Summary The aim of our study was to identify the prevalence of PPIs among geriatric patients in an inpatient setting. We found that 80.6% of patients were prescribed at least one medication outlined in the first class of the 2019 Beers Criteria. The top five drugs were PPIs (40.3%), NSAIDs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin sliding level (5.4%). 4.2. Strengths and Limitations To the best of our knowledge, you will find no published studies that evaluate the prevalence of PIMs in accordance with the updated version of the 2019 Beers Criteria in Saudi Arabia. This study identified the most common PIMs among older patients admitted to one of the largest tertiary hospitals in the western region of Saudi Arabia, with the intention to encourage prescribers to use the 2019 Beers Criteria. There were multiple limitations to the present study. First, the sample was collected retrospectively from in-patients only, which does not represent the geriatric populace. Second, this study included the first class of Beers Criteria exclusively, in which not all medications listed in that class were available in our center formulary. Additionally, the indication and period of therapy of the prescribed medications were not evaluated. 4.3. Comparison with Existing Literature Although several drugs were removed from the brand new Beers Requirements, the prevalence of PIMs was higher in today’s research in comparison to that in two earlier studies carried out in Saudi Arabia that relied on old versions from the Beers Requirements. The first research discovered the prevalence to become 72.6% inside a 135 population-based research conducted in Jeddah [13], whereas the other research reported a prevalence of 61% among 400 individuals in Riyadh [16]. Many potential factors donate to the high prevalence of PIMs. Among the potential factors is that lots of prescribers comfortably depend on the same medicine for years and they’re dubious of substitutes. Prescribers must consider that many from the medicines aren’t universally appropriate but instead rely upon a individuals circumstances [17]. Specifically, prescribers should become aware of the explanation of like the medicine in the Beers Requirements [17]. Moreover, wellness systems in a few institutions absence the privilege of flagging medicine detailed in Beers Requirements for extra extreme caution. Furthermore, improved PIMs among geriatrics could be related to the usage of multiple medicines, also called polypharmacy, which includes.Several studies have resolved the prevalence of PIMs in geriatric individuals globally. insulin (5.4%). Conclusions: The prevalence of PIMs can be high among old individuals admitted to a healthcare facility. More attempts are had a need to investigate the factors and develop actions plans to boost concordance to Beers Criteria among health care companies. (%)(%)465 (54.8)260 (53.4)151 (55.1)54 (61.4)Gender(%)438 (51.6)248 (50.9)143 (52.2)47 (53.4)Beers Requirements Medicine Identified684 (80.6%)387 (79.5%)226 (82.5%)71 (80.7%) Open up in another window SD: regular deviation; = 0.94. There is no gender difference in adherence price: 355 (81.1%) in men in comparison to 329 (80.0%) in females; = 0.568. From the 34 PIMs defined as demonstrated in Desk 2, the very best five recommended medicines or medicine classes had been proton pump inhibitors (PPIs) 741 (40.3%) prescriptions/purchases, NSAIDs 187 (10.2%) prescriptions/purchases, metoclopramide 171 (9.3%) prescriptions/purchases, benzodiazepines 155 (8.4%) prescriptions/purchases, and insulin 99 (5.4%) prescriptions/purchases. Desk 2 The mostly encountered potentially unacceptable medicine (PIMs) according to the 2019 Beers Requirements. thead th align=”middle” valign=”middle” design=”border-top:solid slim;border-bottom:solid slim” rowspan=”1″ colspan=”1″ Medication /th th align=”middle” valign=”middle” design=”border-top:solid slim;border-bottom:solid slim” rowspan=”1″ colspan=”1″ All Age groups br / 849 (100%) /th th align=”middle” valign=”middle” design=”border-top:solid slim;border-bottom:solid slim” rowspan=”1″ colspan=”1″ 65C75 br / 487 (57.3%) /th th align=”middle” valign=”middle” design=”border-top:good thin;border-bottom:solid slim” rowspan=”1″ colspan=”1″ 76C85 br / 274 (32.3%) /th th align=”middle” valign=”middle” design=”border-top:good thin;border-bottom:solid slim” rowspan=”1″ colspan=”1″ 85 br / 88 (10.4%) /th /thead PPI741 (40.3%)435 (23.7%)251 (13.7%)55 (3.0%)NSAID187 (10.2%)121(6.6%)58 (3.2%)8 (0.4%)Metoclopramide171 (9.3%)100 (5.4%)55 (3.0%)16 (0.9%)Benzodiazepines155 (8.4%)85 (4.6%)57 (3.1%)13 (0.7%)Insulin99 (5.4%)67 (3.6%)25 (1.4%)7 (0.4%) Open up in another home window %: percentage; PPIs: proton pump inhibitors (omeprazole and pantoprazole); NSAIDs: non-steroidal anti-inflammatory medicines (diclofenac and ibuprofen); Benzodiazepines: (diazepam and lorazepam); Insulin: insulin slipping scale. 4. Dialogue 4.1. Overview The purpose of our research was to recognize the prevalence of PPIs among geriatric individuals within an inpatient establishing. We discovered that 80.6% of individuals were recommended at least one medication detailed in the high grade from the 2019 Beers Criteria. The top five drugs were PPIs (40.3%), NSAIDs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin sliding level (5.4%). 4.2. Advantages and Limitations To the best of our knowledge, you will find no published studies that evaluate the prevalence of PIMs in accordance with the updated version of the 2019 Beers Criteria in Saudi Arabia. This study identified the most common PIMs among older individuals admitted to one of the largest tertiary private hospitals in the western region of Saudi Arabia, with the intention to encourage prescribers to use the 2019 Beers Criteria. There were multiple limitations to the present study. First, the sample was collected retrospectively from in-patients only, which does not represent the geriatric human population. Second, this study included the first class of Beers Criteria exclusively, in which not all medications listed in that class were available in our center formulary. Additionally, the indicator and period of therapy of the prescribed medications were not evaluated. 4.3. Assessment with Existing Literature Although several medicines were removed from the new Beers Criteria, the prevalence of PIMs was higher in the current study compared to that in two earlier studies carried out in Saudi Arabia that relied on older versions of the Beers Criteria. The first study found the prevalence to be 72.6% inside a 135 population-based study conducted in Jeddah [13], whereas the other study reported a prevalence of 61% among 400 individuals in Riyadh [16]. Several potential reasons contribute to the high prevalence of PIMs. One of the potential reasons is that many prescribers.Methods: The 2019 Beers Criteria were used to assess PIMs in all inpatient prescribed medications focusing on the first class (we.e., drug/drug class to be avoided in older adults). reasons and develop action plans to improve concordance to Beers Criteria among healthcare companies. (%)(%)465 (54.8)260 (53.4)151 (55.1)54 (61.4)Gender(%)438 (51.6)248 (50.9)143 (52.2)47 (53.4)Beers Criteria Medication Identified684 (80.6%)387 (79.5%)226 (82.5%)71 (80.7%) Open in a separate window SD: standard deviation; = 0.94. There was no gender difference in adherence rate: 355 (81.1%) in males compared to 329 (80.0%) in females; = 0.568. Of the 34 PIMs identified as demonstrated in Table 2, the top five prescribed medications or medication classes were proton pump inhibitors (PPIs) 741 (40.3%) prescriptions/orders, NSAIDs 187 (10.2%) prescriptions/orders, metoclopramide 171 (9.3%) prescriptions/orders, benzodiazepines 155 (8.4%) prescriptions/orders, and insulin 99 (5.4%) prescriptions/orders. Table 2 The most commonly encountered potentially improper medication (PIMs) as per the 2019 Beers Criteria. thead th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ Medication /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ All Age groups br / 849 (100%) /th th align=”center” valign=”middle” style=”border-top:solid thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 65C75 br / 487 (57.3%) /th th align=”center” valign=”middle” style=”border-top:stable thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 76C85 br / 274 (32.3%) /th th align=”center” valign=”middle” style=”border-top:stable thin;border-bottom:solid thin” rowspan=”1″ colspan=”1″ 85 br / 88 (10.4%) /th /thead PPI741 (40.3%)435 (23.7%)251 (13.7%)55 (3.0%)NSAID187 (10.2%)121(6.6%)58 (3.2%)8 (0.4%)Metoclopramide171 (9.3%)100 (5.4%)55 (3.0%)16 (0.9%)Benzodiazepines155 (8.4%)85 (4.6%)57 (3.1%)13 (0.7%)Insulin99 (5.4%)67 (3.6%)25 (1.4%)7 (0.4%) Open in a separate screen %: percentage; PPIs: proton pump inhibitors (omeprazole and pantoprazole); NSAIDs: non-steroidal anti-inflammatory medications (diclofenac and ibuprofen); Benzodiazepines: (diazepam and lorazepam); Insulin: insulin slipping scale. 4. Debate 4.1. Overview The purpose of our research was to recognize the prevalence of PPIs among geriatric sufferers within an inpatient placing. We discovered that 80.6% of sufferers were recommended at least one medication shown in the high grade from the 2019 Beers Criteria. The very best five drugs had been PPIs (40.3%), NSAIDs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin sliding range (5.4%). 4.2. Talents and Restrictions To the very best of our understanding, a couple of no published research that measure the prevalence of PIMs relative to the updated edition from the 2019 Beers Requirements in Saudi Arabia. This research identified the most frequent PIMs among old sufferers admitted to 1 of the biggest tertiary clinics in the traditional western area of Saudi Arabia, using the objective to encourage prescribers to utilize the 2019 Beers Requirements. There have been multiple limitations for this research. First, the test was gathered retrospectively from in-patients just, which will not represent the geriatric people. Second, this research included the high grade of Beers Requirements exclusively, where not all medicines listed for the reason that course were obtainable in our middle formulary. Additionally, the sign and length of time of therapy from the recommended medicines were not examined. 4.3. Evaluation with Existing Books Although several medications were taken off the brand new Beers Requirements, the prevalence of PIMs was higher in today’s research in comparison to that in two prior studies executed in Saudi Arabia that relied on old versions from the Beers Requirements. The first research discovered the prevalence to become 72.6% within a 135 population-based research conducted in Jeddah [13], whereas the other research reported a prevalence of 61% among 400 EX 527 (Selisistat) sufferers in Riyadh [16]. Many potential factors donate to the high prevalence of PIMs. Among the potential factors is that lots of prescribers comfortably depend on the same medicine for years and they’re dubious of substitutes. Prescribers must consider that many from the medicines aren’t universally appropriate but instead rely upon a sufferers circumstances [17]. Specifically, prescribers should become aware of the explanation of like the medicine in the Beers Requirements [17]. Moreover, wellness systems in a few institutions absence the privilege of flagging medicine shown in Beers Requirements for extra extreme care. Furthermore, elevated PIMs among geriatrics could be related to the usage of multiple medicines, also called polypharmacy, which includes elevated in geriatrics in the modern times [18,19]. Regarding to our outcomes, the most regularly recommended PIM was PPIs with an interest rate of 40.3%. This result was in keeping with a Chinese retrospective cross-sectional research that was executed in 2017 where the PPI make use of price was 41.9% [12]. Histamine-2 receptor antagonists could be utilized as substitute medicine to PPIs properly, however the Beers Requirements recommend against its make use of in sufferers with delirium because of threat of worsening.All authors have read and decided to the posted version from the manuscript. Funding This research received no external funding. Conflicts appealing The authors declare no conflict appealing. Footnotes Publishers Take note: MDPI remains neutral in regards to to jurisdictional promises in published maps and institutional affiliations.. Outcomes: The mean age group was 75.17 7.66 years. A complete of 684 (80.6%) sufferers were prescribed at least one medicine listed in the first-class group of the 2019 Beers Requirements. Top five medications had been proton pump inhibitors (40.3%), non-steroidal anti-inflammatory medications (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is certainly high among old sufferers admitted to a healthcare facility. More initiatives are had a need to investigate the factors and develop actions plans to boost concordance to Beers Criteria among health care suppliers. (%)(%)465 (54.8)260 (53.4)151 (55.1)54 (61.4)Gender(%)438 (51.6)248 (50.9)143 (52.2)47 (53.4)Beers Requirements Medicine Identified684 (80.6%)387 (79.5%)226 (82.5%)71 (80.7%) Open up in another window SD: regular deviation; = EX 527 (Selisistat) 0.94. There is no gender difference in adherence price: 355 (81.1%) in men in comparison to 329 (80.0%) in females; = 0.568. From the 34 PIMs defined as proven in Desk 2, the very best five recommended medicines or medicine classes had been proton pump inhibitors (PPIs) 741 (40.3%) prescriptions/purchases, NSAIDs 187 (10.2%) prescriptions/purchases, metoclopramide 171 (9.3%) prescriptions/purchases, benzodiazepines 155 (8.4%) prescriptions/purchases, and insulin 99 (5.4%) prescriptions/purchases. Desk 2 The mostly encountered potentially unacceptable medicine (PIMs) according to the 2019 Beers Requirements. thead th align=”middle” valign=”middle” design=”border-top:solid slim;border-bottom:solid slim” rowspan=”1″ colspan=”1″ Medication /th th align=”middle” valign=”middle” design=”border-top:solid slim;border-bottom:solid slim” rowspan=”1″ colspan=”1″ All Age range br / 849 (100%) /th th align=”middle” valign=”middle” design=”border-top:solid slim;border-bottom:solid slim” rowspan=”1″ colspan=”1″ 65C75 br / 487 (57.3%) /th th align=”middle” valign=”middle” design=”border-top:good thin;border-bottom:solid slim” rowspan=”1″ colspan=”1″ 76C85 br / 274 (32.3%) /th th align=”middle” valign=”middle” design=”border-top:good thin;border-bottom:solid slim” rowspan=”1″ colspan=”1″ 85 br / 88 (10.4%) /th /thead PPI741 (40.3%)435 (23.7%)251 (13.7%)55 (3.0%)NSAID187 (10.2%)121(6.6%)58 (3.2%)8 (0.4%)Metoclopramide171 (9.3%)100 (5.4%)55 (3.0%)16 (0.9%)Benzodiazepines155 (8.4%)85 (4.6%)57 (3.1%)13 (0.7%)Insulin99 (5.4%)67 (3.6%)25 (1.4%)7 (0.4%) Open up in another home window %: percentage; PPIs: proton pump inhibitors (omeprazole and pantoprazole); NSAIDs: non-steroidal anti-inflammatory medications (diclofenac and ibuprofen); Benzodiazepines: (diazepam and lorazepam); Insulin: insulin slipping scale. 4. Dialogue 4.1. Overview The purpose of our research was to recognize the prevalence of PPIs among geriatric sufferers within an inpatient placing. We discovered that 80.6% of sufferers were recommended at least one medication detailed in the high grade from the 2019 Beers Criteria. The very best five drugs had been PPIs (40.3%), NSAIDs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin sliding size (5.4%). 4.2. Talents and Restrictions To the very best of our understanding, you can find no published research that measure the prevalence of PIMs relative to the updated version of the 2019 Beers Criteria in Saudi Arabia. This study identified the most common PIMs among older patients admitted to one of the largest tertiary hospitals in the western region of Saudi Arabia, with the intent to encourage prescribers to use the 2019 Beers Criteria. There were multiple limitations to the present study. First, the sample was collected retrospectively from in-patients only, which does not represent the geriatric population. Second, this study included the first class of Beers Criteria exclusively, in which not all medications listed in that class were available in our center formulary. Additionally, the indication and duration of therapy of the prescribed medications were not evaluated. 4.3. Comparison with Existing Literature Although several drugs were removed from the new Beers Criteria, the prevalence of PIMs was higher in the current study compared to that in two previous studies conducted in Saudi Arabia that relied on older versions Rabbit Polyclonal to MGST3 of the Beers Criteria. The first study found the prevalence to be 72.6% in a 135 population-based study conducted in Jeddah [13], whereas the other study reported a prevalence of 61% among 400 patients in Riyadh [16]. Several potential reasons contribute to the high prevalence of PIMs. One of the potential reasons is that many prescribers comfortably rely on the same medication for years and they are suspicious of substitutes. Prescribers must take into consideration that many of the medications are not universally appropriate but rather depend upon a patients circumstances [17]. In particular, prescribers should be aware of the rationale of including the medication in the Beers Criteria [17]. Moreover, health systems in some institutions lack the privilege of flagging medication listed in Beers Criteria for extra caution. Furthermore, increased PIMs.