Personalized Geriatric Medication with Application of the Geriatric Screening Tool (GST): A Public Health Approach to Rational Drug Use in Elderly Patients

Abstract

Background: Polypharmacy and inappropriate prescribing in older adults represent growing public health concerns, contributing to adverse drug reactions, increased healthcare costs, and preventable morbidity. The Geriatric Screening Tool (GST) is a multidimensional framework designed to optimize pharmacotherapy by assessing functional, cognitive, and medication-related parameters. This study evaluated the impact of GST-guided deprescribing on medication safety and rational drug use among elderly patients in a tertiary care setting.

Methods: A prospective observational study was conducted among 319 patients aged ≥60 years. Baseline demographic, clinical, and pharmacological data were collected, and the GST was applied to identify potentially inappropriate medications (PIMs), assess polypharmacy, and guide deprescribing interventions. Statistical analyses using SPSS v27 included paired t-tests, Wilcoxon signed-rank tests, ANOVA, Chi-square, and regression models.

Results: The mean age of patients was 77.5±10.4 years, with 53.3% females. Pre-intervention, all patients exhibited polypharmacy (mean 6.0 drugs per patient). Post-GST intervention, the mean drug count decreased to 4.1 (t=46.606, p<0.001), and PIM prevalence dropped from 6.0% (n=19) to 0%. The most frequent PIMs were tramadol, digoxin, and diclofenac. Regression analysis identified comorbidity count as a significant predictor of total drug use (β=0.661, p<0.001). Risk stratification improved, with high-risk patients decreasing from 42.3% to 28%.

Conclusion: GST-guided deprescribing significantly improved prescribing appropriateness, reduced polypharmacy, and eliminated PIMs. Integrating GST into routine geriatric care can enhance medication safety and advance public health strategies for rational drug use among ageing populations.