Potentially inappropriate medication uses and associated factors among elderly primary health care clinics attendees: A call to action.

BACKGROUND: Polypharmacy is a significant risk factor for using potentially inappropriate medication (PIM), which is using drugs with more risks than benefits, especially for elders. This study aimed to estimate the prevalence of PIM using Beers Criteria, polypharmacy, and their related risk factors. METHODS: A descriptive cross-sectional study was conducted in West Bank primary health care clinics (PHC)from December 2021 to March 2022. Data were collected from PHC clinic attendees aged 65 and above via an interviewer-administered questionnaire and a review of their medical records. We used the Beers Criteria 2019 update to identify PIM and performed a multivariable analysis to determine its associated factors. RESULTS: The study included 421 older people (197 men and 224 women) with an average age of 73.6 years. The prevalence of polypharmacy was 75.1% (95%CI: 70.6%-79.1%), with an average of six medications dispensed per patient. On the other hand, PIM was identified among 36.8% of the study participants (CI:95%CI: 32.2%- 41.6%). Sulfonylureas were the most common (24.2%) reported PIM, followed by peripheral alpha-blockers (4.3%), non-steroidal anti-inflammatory drugs (3.1%), proton pump inhibitors (2.9%), and central nervous system medications (2.1%). Hyperpolypharmacy (> 10 drugs) [aOR = 4.1, 95%CI: 1.6-10.7], polypharmacy [aOR = 2.8, 95%CI: 1.4-5.4], and Diabetes [aOR = 3.5, 95%CI: 2.0-6.0] are the main associated factors of PIM. CONCLUSION: This study found that over one-third of the older people attending PHC clinics have PIM, with polypharmacy and Diabetes being the main predicting variables. Improving physicians' awareness of clear and specific PIM lists can reduce the number of PIM prescribed and decrease their impact.

The association between renal impairment and polypharmacy among older Palestinian patients: a multi-center cross-sectional study.

PURPOSE: This study aimed to examine the association between renal impairment and polypharmacy among older Palestinian patients visiting primary healthcare centers and to examine potentially inappropriate medications among older patients. METHODS: A cross-sectional study was conducted among PHC clinic attendees aged 65 and older. We used medical records and an interviewer-administered questionnaire for data collection. Participants with eGFR less than 60mls/min/1.73 m2 were categorized as renal impaired; we then calculated the prevalence of renal impairment and used Poisson multivariable regression model with robust variance to identify associated factors. Beer's criteria and literature reviews were used to evaluate renal impairment patients' medication and to determine the frequency of PIPs. RESULTS: The study included 421 participants (224 female, 197 male), and 66.3% were between the ages of 65 and 75. The prevalence of renal impairment was 30.2% (95%CI: 25.8-34.6%). Polypharmacy [aPR = 2.7, 95%CI: 1.7-4.3], stroke [aPR = 2.6, 95%CI: 1.1-2.3], females [aPR = 1.7, 95%CI: 1.2-2.5], and older patients over the age of 80 [aPR = 2.4, 95%CI: 1.6-3.5] were the main factors associated with renal impairment. RAAS (54.3%), metformin (39.3%), and sulfonylurea (20.4%) were the most frequently reported PIP in renal impairment patients. CONCLUSION: This study demonstrates a relationship between polypharmacy and renal impairment. Some people with renal impairment receive drugs that those with kidney illness should avoid or use with caution. It is important to prescribe only necessary medication, choose non-nephrotoxic alternatives, and frequently monitor renal function.