The prevalence of polypharmacy and prescription of potentially inappropriate medications in the elderly
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Date
2021-03
Authors
Isaacs, Gavin Sean
Journal Title
Journal ISSN
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Publisher
University of the Free State
Abstract
Background: The proportion of the elderly population, considered to be the main consumers of medicine, is on the increase. High multimorbidity prevalence in elderly increases the risk for appropriate- and inappropriate polypharmacy. Polypharmacy increase the risk for adverse drug reactions and drug events, drug-interactions and is associated with an increased risk of patient harm. Polypharmacy in the elderly correlates with potentially inappropriate medication prescription. Objectives: To determine the prevalence of polypharmacy and potentially inappropriate medication (PIM) prescription at the geriatric outpatient clinic, Universitas Academic Hospital between 1 January 2015 and 31 December 2019. Methods: A retrospective descriptive analytical study evaluating chronic medication prescriptions of all participants aged 65 years and older that attend the geriatric outpatient clinic at Universitas Academic Hospital over a 5-year period. Prescriptions were reviewed for quantity of medicines prescribed per participant and potentially inappropriate medication prescription. Results: A total of 786 participants were included in the study. The majority of patients were aged between 75 and 84 years. The prevalence of polypharmacy was 84.3% of which the majority was female. A mean number of 9.5 medications were prescribed, ranging from 0 to 23 medications. Overall PIM prevalence was 90.2%. Proton pump inhibitors, amitriptyline, insulin sliding scale, promethazine, doxazosin, digoxin and antipsychotics were the most frequently prescribed PIMs. The three most frequently used PIMs in the category of drugs to be used with caution in older adults were aspirin, the loop diuretic furosemide and tramadol. Fifty-two participants (6.6%) were on a combination of ≥ 3 drugs which can lead to potentially clinically important drug-drug interactions. Conclusion: A high prevalence of both polypharmacy and PIM was found. Limited data is available for the South African geriatric population.
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Keywords
Dissertation (M.Med. (Internal Medicine) -- University of Free State, 2021, Polypharmacy, Geriatric, Elderly, Potentially inappropriate medication, Multimorbidity, Beers criteria