OBJECTIVES: To assess the knowledge of health care providers (HCPs) about inappropriate prescribing (IP) in geriatrics, and their confidence in prescribing for this population.

METHODS: Six clinical vignettes were developed based on 2015 Beers criteria and the STOPP/START criteria version 2 to assess the knowledge. The confidence was investigated by asking the HCPs about their agreement on the following statement “I have confidence in my ability to recommend appropriate medications for the older patients”. The scale was validated by expert panel, piloted on 34 HCPs and then distributed to 123 physicians and clinical pharmacists working in general medical wards of two tertiary hospitals in Malaysia.

RESULTS: The scale content validity index value of 0.95 and the Cronbach’s Alpha value of 0.717 indicate good content validity and reliability, respectively. Of the 82 HCPs who completed the questionnaire, 35% were clinical pharmacists, 9.8% had ever undergone a training in geriatric medicine, and 70.8% stated that about 25% of their patients are elderly. Only 7.3% had ever used the STOPP/START or Beers criteria when prescribing for older patients, and 60% of the respondents had never heard of either criteria. The mean (SD) score in knowledge part was 3.65 (1.46) points out of 6 and only 27 HCPs (22.9%) scored high (≥ 5 points). The frequent incorrectly answered clinical vignette was that pertaining to long-term pain management in patients with cardiovascular comorbidities. Overall, only 34% of HCPs rated themselves as confident in prescribing for older patients and this was significantly associated with their knowledge score (p = 0.02).

CONCLUSIONS: The study showed low confidence in prescribing for older patients coupled with inadequate knowledge about IP in more than half of the participants Educational program regarding geriatric pharmacotherapy is needed to boost HCP’s knowledge and confidence in prescribing for older patients.