Abstract
Background
Inappropriate prescribing in elderly patients is a widespread health problem. It is associated with increased drug-related problems and health expenditure.
Aims
To determine the prevalence and types of potentially inappropriate medications (PIM) prescribed to elderly patients with polypharmacy and the factors associated with their use in these patients.
Methods
A cross-sectional study conducted among 228 elderly hospitalized patients with polypharmacy. Elderly patients were defined as patients ≥65 years of age, and polypharmacy was defined as taking ≥5 drugs. Based on previously published criteria (Beers and STOPP), a list of 32 PIM was developed using a Delphi technique, which was used as a tool to detect the prevalence of PIM. Age, gender, comorbidity, patients’ functional status, and complete medication history were recorded to evaluate as variables related to PIM. The association between PIM used and independent variables was also assessed.
Results
The prevalence of PIM used among the hospitalized elderly patients was 64%. PIM use according to STOPP criteria was identified in 44% of patients, whereas Beers-listed PIM were identified in 50% of patients. The most frequently observed PIM were the combination of nonsteroidal anti-inflammatory drugs (NSAIDs) with antihypertensives and long-term NSAIDs, which account for more than 90 and 75% of the total observed PIM, respectively. Patients with age ≥85 years were more likely to be prescribed PIM. High comorbidity was found to be an independent predictor of PIM use. Polypharmacy with ≥10 drugs prescribed to patients predicted the presence of PIM.
Discussion
The study showed a high prevalence of PIM use among hospitalized elderly patients. The consensus-validated list of PIM was a useful tool for screening inappropriate prescribing in this particular patient population.
Conclusion
Our findings support the need for measures to improve the quality of drug treatment in the elderly Pakistani population, especially among dependent patients with polypharmacy.
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Acknowledgements
The authors thank the Department of Pharmacy, Dow College of Pharmacy, and Dow University of Health Sciences for its support.
Author contributions
This study was conceived and designed by Faizan Mazhar, Shahzad Akram, and Saima Mahmood Malhi. The data acquisition and statistical analysis was performed by Faizan Mazhar, Shahzad Akram. All authors performed a critical revision of the manuscript.
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We do not have any competing conflict to disclose.
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Research ethics committee evaluated the study protocol and granted ethical approval for the conduct of the study.
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Clinical research ethics committee waived the requirement for informed consent for the review of medical records.
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Mazhar, F., Akram, S., Malhi, S.M. et al. A prevalence study of potentially inappropriate medications use in hospitalized Pakistani elderly. Aging Clin Exp Res 30, 53–60 (2018). https://doi.org/10.1007/s40520-017-0742-7
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DOI: https://doi.org/10.1007/s40520-017-0742-7