| Database | Search term and strategy |
|---|---|
| Google Scholar | (older OR elderly OR senior OR aged OR frail OR geriatric OR beers OR stopp OR start) AND (‘potentially inappropriate medication’ OR ‘Deprescribing’ OR ‘Inappropriate prescribing’ OR ‘polypharmacy’) AND (‘nepal’) |
| PubMed | 1.Strategy for Population: (((((“Aged”[Mesh]) OR “Frail Elderly”[Mesh])) OR (elderly OR elder OR geriatric OR “elderly people” OR “elderly person” OR “elderly persons” OR “old people” OR senior OR seniors OR “older adults” OR “older adult”))) |
| 2.Strategy for Concept: (((((((“Potentially Inappropriate Medication List”[Mesh]) OR “Deprescriptions”[Mesh]) OR “Inappropriate Prescribing”[Mesh]) OR “Polypharmacy”[Mesh])) OR (deprescrib* OR STOPP[tiab] OR Beers[tiab] OR PIM[tiab] OR “potentially inappropriate medications” OR polypharmacy)) OR (discontinu* OR inappropriate OR “high risk” OR unnecessary OR optimiz* OR optimis* OR rationaliz* OR rationalis* OR futility OR futile OR non-essential AND medic*))) OR (((prescription pattern[Title/Abstract]) OR (prescription error[Title/Abstract])) OR (drug utilisation pattern[Title/Abstract])) OR (“potentially inappropriate medication”[Title/Abstract]) | |
| 3.Strategy for Context: (((“western nepal”) OR (“eastern nepal”)) OR (“central nepal”)) OR (Nepal) | |
| 4.Final search strategy for PubMed: Strategy 1 AND Strategy 2 ANDStrategy 3 | |
| Embase | 1.Strategy for Population: ‘older adults’/exp OR ‘older adults’ OR aged OR ‘frail elderly’/exp OR ‘frail elderly’ |
| 2.Strategy for Concept: ‘potentially inappropriate medication’/exp OR ‘potentially inappropriate medication’ OR deprescription OR ‘polypharmacy’/exp OR polypharmacy OR ‘unnecessary prescribing’ OR ‘beers criteria’ OR ‘stopp start criteria’/exp OR ‘stopp start criteria’ | |
| 3.Strategy for context: ‘nepal’/exp OR nepal | |
| 4.Final search strategy for PubMed: Strategy 1 AND Strategy 2 AND Strategy 3 |
| Author (Year) | Setting, location | Duration | Study design | Sample size (age) | Primary Findings | Secondary findings | ||
|---|---|---|---|---|---|---|---|---|
| PIM% | Tools used | Frequently prescribed PIM (%) | Polypharmacy % | |||||
| Shrestha S et al. (2024) | Private hospital, Biratnagar | 6 months (March 2022 to August 2022) | Retrospective cross-sectional study | n=225 (≥65 years) | 18.05% | Beers 2015 updated criteria | Proton pump inhibitors (39.09%), NSAIDs (25.49%) | NA |
| Chaudhary SK. (2021) | Community pharmacy, Bhaktapur | 3 months (December 2020 to March 2021) | Cross-sectional study | n=114 (>60 years) | 38.50% as per STOPP criteria and 8.70% as per START criteria | STOPP and START criteria | NSAIDs (25.3%) | 44.70% patients 5 to 7 drugs per prescription followed by 8 to 9 drugs per prescription in 18.40% |
| Giri SA et al. (2020) | Teaching Hospital, Pokhara | 4 months (August 2018 to November 2018) | A prospective cross-sectional study | n=403 (≥65 years) | 21.60% | Beers 2015 updated criteria | NSAIDs (44%), Anticholinergics (18%) | 49.13% (high-level polypharmacy 4.96%) |
| Rijal S et al. (2019) | Zonal Hospital, Biratnagar | 4 months (May 2018 to August 2018) | A prospective cross- sectional study | n=200 (≥60 years) | 14% | Beers criteria 2012 | Benzodiazepines (46.43%), Antiemetic- Dopamine agonist (28.57%) | 62% |
| Sah AK et al. (2017) | Teaching Hospital, Bharatpur | 12 months (November 2012 to October 2013) | A prospective observational analysis | n=869 (≥65 years) | 34.30% | Beers criteria | Antihistaminics (12%), Anticholinergics (10.43%) | NA |
| Basnet S et al. (2016) | Teaching Hospital, Bharatpur | 2 months (January and February 2014) | Single-center retrospective cross- sectional and observational study | n=225 (≥65 years) | 7.21% | Beers criteria | Benzodiazepines (25.56%). NSAIDs (16.54%) | 86.66% (33.30% high level polypharmacy, >10 drugs) |
| Sapkota S et al. (2011) | Teaching Hospital, Kathmandu | 3 months (April to June 2010) | A retrospective study | n=305 (≥65 years) | 53% | Beers criteria | Benzodiazepines (32.42%), NSAIDs (29.67%) | NA |
