Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

ObjectivesTo assess the prevalence of potentially inappropriate medication (PIM) use in Hong Kong older patients visiting general outpatient clinics (GOPCs) between 2006 and 2014 and to identify factors associated with PIM use among older adults visiting GOPCs in 2014.DesignCross-sectional study.SettingGOPC.ParticipantsTwo study samples were constructed including a total of 844 910 patients aged 65 and above from 2006 to 2014 and a cohort of 489 301 older patients in 2014.MeasurementsTwo subsets of the 2015 American Geriatrics Society Beers criteria—PIMs independent of diagnosis and PIMs due to drug–disease interactions—were used to estimate the prevalence of PIM use over 12 months. PIMs that were not included in the Hospital Authority drug formulary or with any specific restriction or exception in terms of indication, dose or therapy duration were excluded. Characteristics of PIM users and non-PIM users visiting GOPCs in 2014 were compared. Independent associations between patient variables and PIM use were assessed by stepwise multivariable logistic regression analysis.ResultsThe 12-month period prevalence of PIM use decreased from 55.56% (95% CI 55.39% to 55.72%) in 2006 to 47.51% (95% CI 47.37% to 47.65%) in 2014. In the multivariable regression analysis, the strongest factor associated with PIM use was the number of different drugs prescribed (adjusted OR, AOR 23.01, 95% CI 22.36 to 23.67). Being female (AOR 0.89, 95% CI 0.85 to 0.87 for males vs females) and having a greater number of GOPC visits (AOR 1.83, 95% CI 1.78 to 1.88) as well as more than six diagnoses (AOR 1.43, 95% CI 1.36 to 1.52) were associated with PIM use.ConclusionsThe overall prevalence of PIM use in older adults visiting GOPCs decreased from 2006 to 2014 in Hong Kong although the prevalence of PIM use was still high in 2014. Patients with female gender, a larger number of medications prescribed, more frequent visits to GOPCs, and more than six diagnoses were at higher risk for PIM use.

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Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

Pharmaceuticals ◽

10.3390/ph14090844 ◽

2021 ◽

Vol 14 (9) ◽

pp. 844

Author(s):

Akshaya Srikanth Bhagavathula ◽

Mohammed Assen Seid ◽

Aynishet Adane ◽

Eyob Alemayehu Gebreyohannes ◽

Jovana Brkic ◽

...

Keyword(s):

Older Adults ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

Potentially Inappropriate Medication ◽

Multivariable Logistic Regression Analysis ◽

Routine Practice ◽

Cross Sectional ◽

Inappropriate Medication Use ◽

High Prevalence ◽

Sliding Scale

Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multivariable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.

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Cross sectional study on the prevalence of polypharmacy and potentially inappropriate medications among elderly patients in a tertiary care centre in central Kerala

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210836 ◽

2021 ◽

Vol 8 (3) ◽

pp. 1415

Author(s):

Jubina Bency Anthoorathodi ◽

Aqueen Joju ◽

Ann Mereena Reji ◽

Anupama Pallivalappil Asokan ◽

Anzeem Naseem ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Clinical Care ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

Health Concern ◽

Potentially Inappropriate Medication ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional

Background: Polypharmacy or the concurrent use of multiple medications, is on the rise, especially in the elderly population as they suffer from multiple co-morbidities. Polypharmacy has been reported to increase the risks for inappropriate medication intake. Objectives: The aim was to investigate the prevalence of polypharmacy and usage of potentially inappropriate medication using Beer’s criteria and to find out the various risk factors of polypharmacy in hospitalised elderly.Methods: A cross sectional study was done in patients aged 60 years and above using a pre designed semi structured questionnaire and from their case records to assess the pattern of polypharmacy by different socio-demographic characteristics and also to found out the risk factors of polypharmacy.Results: 50 patients aged 60 and above were involved in our study out of which, 46% were females and 54% were males. Mean age of our study population was 71.5±8.3. Among them, 30 were hypertensive, 27 were diabetic, 9 of them had dyslipidaemia and 8 of them had coronary artery disease Mean number of medication use was 5.1±4.1. Polypharmacy was observed in 42% of the patients. 20% patients received potentially inappropriate drugs from Beer’s list. We also found significant association of polypharmacy with diabetes mellitus and hypertension.Conclusions: The present study has shown polypharmacy and usage of potentially inappropriate medication as an emerging public health concern. Diabetes mellitus and hypertension were found to be risk factors of polypharmacy. Deprescription should be integrated into clinical care and prescribers need to be educated about Beers criteria and encouraged for rational prescription.

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