Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan

Abstract

BackgroundReports from drug utilization reviews are important tools employed in the assessment of healthcare practices. The objective of this study was to evaluate drug utilization patterns among elderly hospitalized patients on poly-pharmacy regimens in Pakistan. MethodsA descriptive, non-experimental, cross-sectional study was carried out from December 2015 to March 2016 in six tertiary-care hospitals in the Punjab province of Pakistan. The population under study were patients aged ≥60 years, taking ≥5 medicines per day (i.e., patients on poly-pharmacy) and who were hospitalized in the selected tertiary-care hospitals. In this study, data was collected from 600 hospitalized elderly patients (100 patients per hospital). All medicines prescribed on each in-patient chart were noted on a pre-designed pro-forma sheet and were classified under the Anatomical Therapeutic Chemical (ATC) classification system. Multiple linear regression analysis was used to determine the independent factors associated with poly-pharmacy in this cohort. Statistical Package for Social Sciences (SPSS) was used to analyze the data. P-value < .05 indicated statistical significance.ResultsIn 600 hospitalized in-patient (male 52.7% and female 47.3%) medication charts, 3179 medicines were prescribed. The most commonly prescribed drug classes were: A: alimentary tract and metabolism 80% (A02: drugs for acid related disorders 64.5%, A03: drugs for functional gastrointestinal disorders 21.5%), N: nervous system 66.3% (N02: analgesics 67.2%, N03: antiepileptic’s 11.2%), J: anti-infectives for systemic use 62.2% (J01: antibacterial for systemic use 82.5%, J04: antimycobacterials 15.3%) and C: cardiovascular system 48.3% (C07: beta blocking agents 19.8%, C10: lipid modifying agents 16.5%), respectively. The most commonly prescribed active substances were: A02BC01 (omeprazole 51.3%), N02BE01 (paracetamol 50.8%) and J01DD04 (ceftriaxone 40.2%), respectively. In multiple linear regression analysis, male gender (95% CI −.205, −.006, p = .039, B = −.091), being divorced (95% CI −.604, −.136, p = .002, B = −.130) and presence of comorbidity (95% CI .068, .267, p = .001, B = .144) were the independent factors associated with increased drug use among elderly hospitalized patients on poly-pharmacy.ConclusionsThe rational use of medicines is of utmost importance, most particularly in the elderly population. More consideration should be given to rationalizing pharmacotherapy in elderly hospitalized patients who are on poly-pharmacy regimens in Pakistan.Electronic supplementary materialThe online version of this article (doi:10.1186/s40545-017-0112-z) contains supplementary material, which is available to authorized users.

Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer’s Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan

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Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A multicenter, cross-sectional study in Lahore, Pakistan

“…A study conducted in Netherlands reported that ADEs pertaining to medication interventions account for 0.2% per hospital admission [ 16 ]. The misuse of antibiotics is a matter of concern because of its association with a number of potentially harmful ADEs which may include end-organ damage, hypersensitivity reactions, and super-infections with various antibiotic-resistant organisms [ 17 – 19 ].…”

A importância da atenção farmacêutica como ferramenta para a promoção do uso racional de medicamentos em idosos que fazem uso de polifarmácia: uma revisão integrativa

“…Concordando com as ideias anteriores, os estudos realizados por Sarwar, et al, (2017), Linden, et al (2016, Whitman, Degregory, Morris, Mohile, e Ramsdale (2018) apontam para os riscos que a polifarmácia pode desencadear na saúde individual e coletiva dos pacientes idosos, mostrando que medidas de atenção farmacêutica, quando incorporadas como parte do tratamento tradicional, tendem a ter grandes benefícios no que tange a identificação e resolução de problemas relacionados a medicamentos, incluindo o polifarmácia. Afirmam ainda, que para se reverter e prevenir essas situações, é crucial que mais ênfase seja atribuída à perspectiva da racionalização da terapia dos idosos polimedicados, trazendo mais segurança para processo.…”