Optimizing Geriatric Prescriptions: Development, Validation, and Pilot Testing of Novel Quality Assessment Tool

Background: Prescriptions are medication plans communicated between prescribers and pharmacists for patients. An ideal prescription must be rational, evidence-based, complete, and clear, and enhance the therapeutic outcome of the patient. Elderly patients are vulnerable to multiple illnesses and thereby prone to polypharmacy and drug related problems. Objectives: Prescription appropriateness and quality of prescribing are a serious concern in geriatric care. This study aims to develop and validate a clinical tool to assess the quality and suitability of geriatric prescriptions. Materials and Methods: The study population consisted of elderly inpatients. The tool development followed item selection, defining the need for each item, drafting, Delphi analysis, pre-testing, and validation. The tool was tested for feasibility, validity, and reliability during validation. Results: The tool comprised assessing prescribing information, quality indicators, drug use indicators, cost indicators, and morbidity indicators. The Prescription Quality Assessment Tool in Geriatrics (PQATG) was found to be feasible after pretesting. The panel achieved consensus on 20 items. The content validity ratio = 0.6, with the sum of content validity index being 16.082. The construct validity test produced a significant correlation, and the intra-class correlation coefficient indicated moderate reliability. The variables PQATG score and number of drugs per prescription were found to be negatively correlated, r (92) = –0.2886, p = .0005371. Pilot studies proved that 86.6% (n = 79) of prescriptions had good quality, 44% (n = 4) rated moderate quality, and 8.8% (n = 8) were poor. Conclusion: The PQATG is a feasible, reliable, valid, and novel tool for evaluating the quality of geriatric prescriptions.