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

Sarwar, Muhammad Rehan; Iftikhar, Sadia; Sarfraz, Muhammad

doi:10.3390/medicina54040057

Cited by 13 publications

(12 citation statements)

References 57 publications

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“…Some published studies in Sweden reported similar results (Haider et al, 2007;Haider et al, 2009). Furthermore, studies from Malaysia (Ong et al, 2018) and Pakistan (Sarwar et al, 2018) also suggested that older patients with low level education were significantly associated with a higher rate of polypharmacy. The potential explanation might be that patients with a lower level of education are less aware of their basic health needs and expect clinicians to prescribe a greater number of medications (Abdulrahman, 2003).…”

Section: Discussionmentioning

confidence: 65%

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Zhang

Sundquist

et al. 2020

Front. Pharmacol.

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Polypharmacy is becoming a global health problem. The aims of this study were to evaluate the temporal trends in the prevalence of polypharmacy in Sweden and to explore polypharmacy disparities by age, gender, education, and immigration status. Methods: Polypharmacy and excessive polypharmacy were evaluated using data extracted from the Swedish Prescribed Drug Register between 2006 and 2014. Polypharmacy was defined as being exposed to five or more drugs and excessive polypharmacy was defined as being exposed to 10 or more drugs during 1 month respectively. Average annual percent change (AAPC) was calculated using Joinpoint Statistical Software. Results: The prevalence of polypharmacy increased from 16.9% in 2006 to 19.0% in 2014 with an AAPC of 1.3; the prevalence of excess polypharmacy increased from 3.8% in 2006 to 5.1% in 2014 with an AAPC of 3.4. The prevalence of polypharmacy and excessive polypharmacy increased dramatically with age and peaked up to 79.6% and 36.4% in individuals aged 90 and above respectively. Females and individuals with lower education level were associated with a higher rate of polypharmacy and excessive polypharmacy. Immigrants from Middle-Eastern countries had the highest rate of polypharmacy and excessive polypharmacy, whereas individuals from Western Europe countries had the lowest rate. Conclusion: The prevalence of polypharmacy has increased gradually in Sweden during the past decade. Individuals with older age, female sex, or lower education have a higher rate of polypharmacy and excessive polypharmacy. Immigrants from Middle-Eastern countries showed a higher rate of polypharmacy.

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Section: Discussionmentioning

confidence: 65%

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Zhang

Sundquist

et al. 2020

Front. Pharmacol.

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“…Another factor that confounds the association is SES (educational attainment). SES impacts the quantity and quality of prescriptions (i.e., risk of polypharmacy and inappropriate medications) [8,74,75], as well as distress [76]. Low SES is a risk factor for psychological distress [76], as low SES individuals face more stressors, such as financial problems, unemployment, poverty, and daily stress in their life [77].…”

Section: Discussionmentioning

confidence: 99%

Polypharmacy and Psychological Distress May Be Associated in African American Adults

Assari

Bazargan

2019

Pharmacy

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Background: Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies, however, have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, and stress—in African Americans. Aims: In a national sample of African Americans in the US, this study investigated the association between polypharmacy and psychological distress. Methods: The National Survey of American Life (NSAL, 2003) included 3570 African American adults who were 18 years or over. This number was composed of 2299 women and 1271 men. Polypharmacy (using ≥ 5 medications) and hyper-polypharmacy (using ≥ 10 medications) were the independent variables. Psychological distress was the dependent variable. Age, gender, socioeconomic status (education attainment, income, employment, and marital status), health care access (insurance status and usual place of care), and health status (multimorbidity and psychiatric disorders) were the covariates. Linear multivariable regression was applied to perform the data analysis. Results: Both polypharmacy and hyper-polypharmacy were associated with psychological distress. This association was significant after controlling for all the covariates. Conclusions: African Americans with polypharmacy, particularly those with hyper-polypharmacy, are experiencing higher levels of psychological distress, which itself is a known risk factor for poor adherence to medications. There is a need for a comprehensive evaluation of medications as well as screening for psychopathology in African Americans with multiple medical conditions.

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“…It was reported that elderly patients with higher literacy were more informed about their medicament and health condition and were more likely to be involved in self-monitoring and accepting medical interventions to avoid polypharmacy; thus, resulting in fewer medications. 65 , 151 The critical point to remember is that medicines often cause ADRs beside their therapeutic benefits and effects on the improvement of quality of life; they increase both morbidity and mortality in the elderly. 141…”

Section: Strategies To Reduce and Prevent Polypharmacy In Older Patiementioning

confidence: 99%

<p>The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications</p>

Rahman¹,

Singh²,

Dhingra³

et al. 2020

TCRM

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COVID-19 pandemic is inducing acute respiratory distress syndrome, multiorgan failure, and eventual death. Respiratory failure is the leading cause of mortality in the elderly population with pre-existing medical conditions. This group is particularly vulnerable to infections due to a declined immune system, comorbidities, geriatric syndrome, and potentially inappropriate polypharmacy. These conditions make the elderly population more susceptible to the harmful effects of medications and the deleterious consequences of infections, including MERS-CoV, SARS-CoV, and SARS-CoV-2. Chronic diseases among elderlies, including respiratory diseases, hypertension, diabetes, and coronary heart diseases, present a significant challenge for healthcare professionals. To comply with the clinical guidelines, the practitioner may prescribe a complex medication regimen that adds up to the burden of pre-existing treatment, potentially inducing adverse drug reactions and leading to harmful side-effects. Consequently, the geriatric population is at increased risk of falls, frailty, and dependence that enhances their susceptibility to morbidity and mortality due to SARS-CoV-2 respiratory syndrome, particularly interstitial pneumonia. The major challenge resides in the detection of infection that may present as atypical manifestations in this age group. Healthy aging can be possible with adequate preventive measures and appropriate medication regimen and follow-up. Adherence to the guidelines and recommendations of WHO, CDC, and other national/regional/international agencies can reduce the risks of SARS-CoV-2 infection. Better training programs are needed to enhance the skill of health care professionals and patient's caregivers. This review explains the public health implications associated with polypharmacy on the geriatric population with pre-existing comorbidities during the COVID-19 pandemic.

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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

Cited by 13 publications

References 57 publications

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

An Increasing Trend in the Prevalence of Polypharmacy in Sweden: A Nationwide Register-Based Study

Polypharmacy and Psychological Distress May Be Associated in African American Adults

<p>The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications</p>

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