{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:47:34Z","timestamp":1788482854964,"version":"build-2803163510"},"reference-count":48,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Polypharmacy and potentially inappropriate medications (PIMs) exposure are common in older adults, especially in emergency departments (EDs) with rapid decisions and incomplete histories. Pharmacist-led medication reconciliation improves safety but is rarely implemented in Iran.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    This study aimed to evaluate the prevalence and patterns of PIM use, medication regimen complexity, and associated factors among elderly patients admitted to the ED.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methodology:<\/jats:bold>\n                    This cross-sectional study of patients aged 65+ years at Alzahra Hospital (October 2023\u2013March 2024) involved medication reconciliation by pharmacy students under supervision. PIMs were identified using the 2023 American Geriatrics Society (AGS) Beers Criteria. Medication complexity and comorbidities were assessed via Medication Regimen Complexity Index (MRCI) and Charlson Comorbidity Index (CCI), with results analyzed through regression.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 200 patients were included (mean age 78.1 \u00b1 7.8 years; males: 109, 54.5%). Polypharmacy was observed in 104 patients (52%). The mean MRCI was 23.8 \u00b1 13.5, and the mean CCI was 2.3 \u00b1 1.6. PIM exposure was identified in 75 patients (37.5%), with 221 PIM prescriptions. The most frequent PIM classes were benzodiazepines (49\/221, 22.2%), atypical antipsychotics (28\/221, 12.7%), opioids (24\/221, 10.9%), and Non-Steroidal Anti\u2013Inflammatory Drugs (NSAIDs: 18\/221, 8.1%). Clinically significant drug\u2013drug interactions occurred in 30 patients (15%). Female sex, mild comorbidity (CCI, 1\u20132), and higher MRCI independently predicted PIM use.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    PIM exposure was frequent among elderly ED patients. Pharmacist-led medication reconciliation effectively identified inappropriate prescribing and complex regimens, supporting the integration of clinical pharmacists into emergency care to improve geriatric medication safety.\n                  <\/jats:p>","DOI":"10.5339\/qmj.2026.8","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T21:30:27Z","timestamp":1772659827000},"source":"Crossref","is-referenced-by-count":2,"title":["Potentially inappropriate medications and regimen complexity among elderly patients in the emergency department: Insights from a pharmacist-led medication reconciliation study"],"prefix":"10.5339","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9792-1428","authenticated-orcid":true,"given":"Sarah","family":"Mousavi","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Hossein Jabbary","family":"Diziche","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran*Correspondance: Sarah Mousavi s.mousavi@pharm.mui.ac.ir"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"issue":"(5-6):","key":"B1","series-title":"Wien Med Wochenschr","first-page":"109\u201313","article-title":"Polypharmacy in elderly people","volume":"172","author":"Dovjak\n \nP","year":"2022"},{"key":"B2","series-title":"Front Public Health","first-page":"743138","article-title":"Impact of polypharmacy, drug-related problems, and potentially inappropriate medications in geriatric patients and its implications for Bulgaria-narrative review and meta-analysis","volume":"10","author":"Krustev\n \nT","year":"2022"},{"issue":"(4):","key":"B3","series-title":"J Clin Psychiatry","first-page":"e363\u201371","article-title":"National trends in antidepressant, benzodiazepine, and other sedative-hypnotic treatment of older adults in psychiatric and primary care","volume":"78","author":"Maust\n \nDT","year":"2017"},{"issue":"(4):","key":"B4","series-title":"Eur Geriatr Med","first-page":"849\u201357","article-title":"Polypharmacy, comorbidity and frailty: a complex interplay in older patients at the emergency department","volume":"13","author":"van Dam\n \nCS","year":"2022"},{"issue":"(4):","key":"B5","series-title":"J Crit Care","first-page":"201\u20135","article-title":"Medication reconciliation: a practical tool to reduce the risk of medication errors","volume":"18","author":"Pronovost\n \nP","year":"2003"},{"key":"B6","series-title":"Braz J Pharm Sci","first-page":"e19832","article-title":"Patients\u2019 medication reconciliation in a university hospital","volume":"58","author":"Magalh\u00e3es\n \nGF","year":"2022;"},{"issue":"(1):","key":"B7","series-title":"Int J Clin Pharm","first-page":"196\u2013201","article-title":"The impact of pharmacist-led medication reconciliation during admission at tertiary care hospital","volume":"40","author":"Abdulghani\n \nKH","year":"2018"},{"issue":"(7):","key":"B8","series-title":"J Am Geriatr Soc","first-page":"2052\u201381","article-title":"American Geriatrics Society 2023 updated AGS Beers Criteria\u00ae for potentially inappropriate medication use in older adults","volume":"71","author":"By the 2023 American Geriatrics Society Beers Criteria\u00ae Update Expert Panel","year":"2023"},{"issue":"(11):","key":"B9","series-title":"Ann Pharmacother","first-page":"1117\u201334","article-title":"Medication regimen complexity measured by MRCI: a systematic review to identify health outcomes","volume":"52","author":"Alves-Conceicao\n \nV","year":"2018"},{"issue":"(3):","key":"B10","series-title":"J Physiother","first-page":"171","article-title":"Charlson comorbidities index","volume":"62","author":"Roffman\n \nCE","year":"2016"},{"issue":"(8):","key":"B11","series-title":"J Am Geriatr Soc","first-page":"2495\u2013505","article-title":"Potentially inappropriate medication use is associated with increased risk of incident disability in healthy older adults","volume":"71","author":"Lockery\n \nJE","year":"2023"},{"issue":"(11):","key":"B12","series-title":"J Clin Med","first-page":"2305","article-title":"Patient- and prescriber-related factors associated with potentially inappropriate medications and drug-drug interactions in older adults","volume":"10","author":"Jang\n \nS","year":"2021"},{"issue":"2025","key":"B13","series-title":"The national form for medication reconciliation","author":"Ministry of Health and Medical Education"},{"issue":"(4):","key":"B14","series-title":"Am J Kidney Dis","first-page":"622\u20137","article-title":"Estimating GFR using the CKD Epidemiology 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Sci","first-page":"e19832","article-title":"Patients\u2019 medication reconciliation in a university hospital","volume":"58","author":"Magalh\u00e3es\n \nGF","year":"2022;"},{"issue":"(1):","key":"B7","series-title":"Int J Clin Pharm","first-page":"196\u2013201","article-title":"The impact of pharmacist-led medication reconciliation during admission at tertiary care hospital","volume":"40","author":"Abdulghani\n \nKH","year":"2018"},{"issue":"(7):","key":"B8","series-title":"J Am Geriatr Soc","first-page":"2052\u201381","article-title":"American Geriatrics Society 2023 updated AGS Beers Criteria\u00ae for potentially inappropriate medication use in older adults","volume":"71","author":"By the 2023 American Geriatrics Society Beers Criteria\u00ae Update Expert Panel","year":"2023"},{"issue":"(11):","key":"B9","series-title":"Ann Pharmacother","first-page":"1117\u201334","article-title":"Medication regimen complexity measured by MRCI: a systematic review to identify health 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\nA","year":"2009"},{"issue":"(5):","key":"B18","series-title":"Acta Psychiatr Scand","first-page":"391\u20133","article-title":"Benzodiazepines in elderly patients","volume":"148","author":"Fava\n \nGA","year":"2023"},{"key":"B19","series-title":"Braz J Psychiatry","first-page":"e20243954","article-title":"Association of typical and atypical antipsychotics with mortality in older adults with schizophrenia: a 5-year multicenter prospective study","volume":"47","author":"Haddad\n \nR","year":"2025;"},{"issue":"(2):","key":"B20","series-title":"CNS Spectr","first-page":"243\u20134","article-title":"Hyponatremia secondary treatment with SSRI antidepressants in adults and elderly","volume":"27","author":"y Nabar\n \nMJM","year":"2022"},{"issue":"(29-30):","key":"B21","series-title":"Dtsch Arztebl Int","first-page":"508\u201318","article-title":"Psychopharmacological treatment in older people: avoiding drug interactions and polypharmacy","volume":"116","author":"Kratz\n \nT","year":"2019"},{"issue":"(4):","key":"B22","series-title":"J Am Geriatr Soc","first-page":"747\u201353","article-title":"Clinical outcomes associated with medication regimen complexity in older people: a systematic review","volume":"65","author":"Wimmer\n \nBC","year":"2017"},{"issue":"(3):","key":"B23","series-title":"Eur Geriatr Med","first-page":"431\u20134","article-title":"Mastering the complexity: drug therapy optimization in geriatric patients","volume":"12","author":"Cherubini\n \nA","year":"2021"},{"issue":"(6):","key":"B24","series-title":"Pharmaceuticals (Basel)","first-page":"869","article-title":"Gender differences in potentially inappropriate medication use among older adults","volume":"16","author":"Alwhaibi\n \nM","year":"2023"}],"container-title":["Qatar Medical 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