Inappropriate medication prescribing, polypharmacy, potential drug-drug interactions and medication regimen complexity in older adults attending three referral hospitals in Asmara, Eritrea: a cross-sectional study
BMC Geriatrics,
Год журнала:
2025,
Номер
25(1)
Опубликована: Фев. 3, 2025
Older
adults
often
face
several
chronic
illnesses
that
require
them
to
take
multiple
medications.
The
increased
number
of
prescribed
medications
has
led
more
complex
medication
regimens,
putting
older
at
a
higher
risk
potential
drug-drug
interactions,
inappropriate
prescribing,
and
adverse
events.
This
study
aimed
assess
prescribing
practices,
polypharmacy,
regimen
complexity,
their
determinants
in
adults.
A
cross-sectional
was
conducted
among
(aged
65
years
above)
who
visited
three
referral
hospitals
Asmara,
Eritrea,
between
June
August,
2023.
stratified
random
sampling
technique
used,
data
were
collected
from
patient
prescriptions,
medical
cards,
through
interviews
with
questionnaire.
Inappropriate
evaluated
using
STOPP
(Screening
Tool
Person's
Prescriptions)/
START
Alert
Right
Treatment)
criteria
version
3.
Potential
interactions
(pDDIs)
complexity
(MRC)
assessed
Lexi-comp
drug
interaction
checker
MRC
index,
respectively.
Descriptive
statistics,
logistic
regression,
Pearson's
correlation
coefficient,
independent
samples
t-test,
one-way
Analysis
Variance,
paired
t-test
employed
IBM
SPSS
(version-26.0).
total
430
respondents,
similar
male
female
ratio,
included.
prevalence
polypharmacy
5.3%
(95%CI:
3.2,
7.5).
Moreover,
the
clinically
significant
pDDI
51%
46,
56).
most
common
medicines
involved
pDDIs
enalapril
(n
=
179)
acetylsalicylic
acid
124).
presence
illness
(AOR
7.58,
95%CI:
3.73,
15.39)
drugs
2.80,
1.91,
4.10)
predictors
pDDIs.
potentially
(PIMs)
omissions
(PPOs)
27.4%
(95%
CI:
23.4,
31.8)
13.3%
10.3,
16.7),
PIMs
long-acting
sulfonylureas
63)
aldosterone
antagonists
19).
Besides,
proton
pump
inhibitors
(PPIs)
41)
cardio-selective
beta-blockers
14)
PPOs
identified.
Age
(AOR:
0.95,
95%
0.92,
0.98),
1.51,
0.81,
2.80),
2.01,
2.69)
factors
associated
PIM.
MRCI
score
determinant
PPO
1.25,
1.14,
1.38).
mean
(SD)
overall
9.1
(3.7),
dose
frequency
being
major
contributor.
(r
0.625,
p
<
0.001).
adults,
highlighting
need
for
immediate
attention
policymakers,
program
managers,
healthcare
professionals.
Язык: Английский
Polypharmacy, drug–drug interactions, and potentially inappropriate medications among older adults: a cross-sectional study in Northeast Ethiopia
Frontiers in Public Health,
Год журнала:
2025,
Номер
13
Опубликована: Апрель 17, 2025
Background
The
global
older
adult
population
is
expected
to
increase
from
524
million
in
2010
1.5
billion
by
2050,
mainly
developing
countries.
Age-related
diseases,
comorbidities,
and
polypharmacy
make
appropriate
prescribing
crucial.
This
study
aimed
assess
the
prevalence
of
polypharmacy,
drug–drug
interaction,
potentially
inappropriate
medication
use
its
factors
an
Ethiopian
hospital.
Methods
A
facility-based
cross-sectional
on
236
patients
aged
65
above
at
Dessie
Comprehensive
Specialized
Hospital
(Jan
2022–Apr
2023)
used
2023
Beers
Criteria
START/STOP
V.3
identify
medications.
Polypharmacy
potential
interactions
were
assessed
using
Micromedex®,
with
descriptive
statistics
binary
logistic
regression
performed
SPSS
version
26.
Result
Of
this
study,
94
(39.8,
95%
CI:
35.7–44.5%)
prescribed
least
one
per
STOPP/START
criteria,
81
(34.3%)
identified
STOPP
13
(5.5%)
START.
According
Criteria,
108
(45.7,
40.1–51.0%)
received
medication.
was
observed
80
(33.9,
29.1–38.5%),
111
(47.0%).
Being
female
(AOR:
2.93),
age
≥75
1.52),
3.20)
linked
Criteria.
Age
70–74
2.30)
3.10)
also
associated
criteria.
Conclusion
Polypharmacy,
interactions,
medications
are
common
among
patients,
age,
sex,
as
contributing
factors.
Future
studies
needed
health
economic
impacts
use.
Язык: Английский
Prevalence of Potentially Inappropriate Medications in Older Adults with Cognitive Impairment or Dementia Attending Memory Clinics: A Systematic Review and Meta-Analysis
Journal of Alzheimer s Disease,
Год журнала:
2024,
Номер
101(4), С. 1107 - 1120
Опубликована: Окт. 8, 2024
Background:
Older
adults
with
dementia
who
are
on
polypharmacy
more
vulnerable
to
the
use
of
potentially
inappropriate
medications
(PIM),
which
can
significantly
increase
risk
adverse
events
and
drug-related
problems
(DRPs).
Objective:
This
systematic
review
meta-analysis
were
conducted
map
prevalence
PIM
use,
polypharmacy,
hyper-polypharmacy
among
older
cognitive
impairment
or
attending
memory
clinics.
Methods:
Ovid
MEDLINE,
EMBASE,
Scopus,
Cochrane
Library,
EBSCOhost
CINAHL,
International
Pharmaceutical
Abstracts
(IPA)
systematically
searched
from
inception
April
22,
2024.
Observational
studies
assessing
PIMs
CI
screened.
A
random-
effects
was
pool
estimates.
Results:
Of
5,787
identified
citations,
11
including
4,571
participants
8
countries
included.
Among
all
included
pooled
38%
(95%
confidence
interval
(CIn):
27–
50%),
highlighting
a
notable
range
20%
78%.
The
analysis
anticholinergics,
benzodiazepines,
non-benzodiazepine
sedatives
as
most
common
PIMs.
Subgroup
revealed
higher
in
USA
(39%;
95%
CIn:
10–
78,
I2
(%)
=
98,
3
studies)
Australia
(36%,
12–
70,
96,
2
Studies).
Additionally,
reported
(60%;
46–
73,
95,
studies),
(The
17.6%;
1
study)
respectively.
Conclusions:
definition
impacts
study
results,
often
than
geographical
variations.
variability
criteria
tools
like
Beers
Screening
Tool
Persons’
Prescriptions
(STOPP)
across
regions
leads
differing
rates.
Язык: Английский
Potentially inappropriate prescribing among older adults with hypertension in China: prevalence and related comorbidities across different outpatient settings
Frontiers in Pharmacology,
Год журнала:
2024,
Номер
15
Опубликована: Авг. 15, 2024
Purpose
Potentially
inappropriate
prescribing
(PIP)
is
commonly
encountered
in
older
adults;
yet,
there
limited
information
on
the
occurrence
of
PIP
among
adults
with
hypertension.
This
study
aims
to
determine
and
compare
prevalence
its
association
comorbidities
adult
outpatients
hypertension
across
hospitals
community
health
centers
(CHCs).
Methods
3-year
(2015–2017)
repeated
cross-sectional
used
electronic
medical
records
from
Shenzhen,
China,
involving
62
678
primary
institutions.
was
defined
using
2019
Beers
Criteria.
Older
(≥65
years)
at
least
one
outpatient
prescription
were
included.
Modified
Poisson
regression
analysis
assess
between
chronic
comorbidities,
healthcare
settings,
PIP.
Results
The
old
2015,
2016,
2017
46.32%,
46.98%,
46.58%
hospitals,
a
sample
size
38,411,
46,235,
50,495,
respectively,
29.14%,
26.66%,
29.84%
CHCs,
26,876,
29,434,
34,775
respectively.
top
four
most
popular
CHCs
proton-pump
inhibitors
(PPIs),
diuretics,
benzodiazepines,
non-cyclooxygenase-selective
non-steroidal
anti-inflammatory
drugs
(NSAIDs),
associated
gastrointestinal
disease
(adjusted
ratio
=
1.54,
95%
confidence
interval
[CI]
1.50–1.59)
mental
behavioral
disorders
1.49,
CI
1.46–1.53)
1.99;
1.95–2.03)
musculoskeletal
system
connective
tissue
1.33;
1.31–1.36)
CHCs.
significantly
higher
hospital
settings
than
1.65;
1.63–1.66).
Conclusion
Among
more
prevalent
strongly
Clinical
pharmacy
integration
needs
be
considered
reduce
this
vulnerable
population.
Язык: Английский
Uso de medicamentos potencialmente inapropriados em idosos internados em um hospital de ensino
Revista Eletrônica Acervo Saúde,
Год журнала:
2024,
Номер
24(8), С. e16741 - e16741
Опубликована: Авг. 25, 2024
Objetivo:
Avaliar
a
prevalência
do
uso
de
medicamentos
potencialmente
inapropriados
(MPI)
em
idosos
internados,
polifarmácia
e
fatores
riscos
associados,
além
identificar
possíveis
Problemas
Relacionados
Medicamentos
(PRM).
Métodos:
Trata-se
um
estudo
transversal
descritivo,
retrospectivo
quantitativo,
conduzido
com
86
indivíduos
ambos
os
sexos,
idade
≥
60
anos,
realizado
julho
outubro
2023
na
Unidade
Clínica
Médica
(UCM)
Hospital
Universitário
da
Universidade
Federal
Maranhão
(HUUFMA).
O
Critério
Beers
(2019)
foi
utilizado
para
avaliar
MPI,
avaliação
PRM
realizada
acordo
Strand.
teste
Qui-Quadrado
Pearson
usado
determinar
as
associações
(p<0,05)
entre
sexo,
polifarmácia.
aprovado
pelo
Comitê
Ética
Pesquisa
(CAAE:
70666623.50000.5086).
Resultados:
Um
total
88,3%
dos
pacientes
apresentou
MPI
prescrição
admissão
à
alta,
mais
prescritos
foram
inibidores
bomba
prótons
(51,11%)
antipsicóticos
(16,29%),
27
tiveram
ou
durante
internação.
Não
se
observou
significância
estatística
variável
sexo
(p=0,859)
presença
(p=0,308).
Conclusão:
Diante
alta
evidenciada
neste
estudo,
educação
saúde
é
essencial
evitar
problemas
agravos
decorrentes
inapropriados.
Sugere-se
ainda
que
o
deve
ser
ampliado
sobre
relação
consonância
estudos
robustos.