Polypharmacy and the Contributing Factors Among Elderly Patients in Shashemene Referral Hospital, West Arsi, Oromia Region, Ethiopia

Geresu, Gudeta Duga; Yadesa, Tadele Mekuria; Abebe, Bontu Aschale

doi:10.4172/1948-593x.1000193

Cited by 4 publications

(12 citation statements)

References 13 publications

(16 reference statements)

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“…These 8 studies comprising a total of 2,068 participants [31][32][33][34][35][36][37][38], representative of the elderly Ethiopian population [32][33][34][35][36][37][38], employing cross-sectional study design [31][32][33][34][35][36][37][38], were published from 2014 [37] to March 2020 [31] and their sample size ranged from 32 [33] to 1,252 [37]. The majority of studies were conducted in Gondar [31,32,[36][37][38], and used a version of the Beers criteria (2003/2012) [34,35,37,38], 2015 STOPP criteria [32,36]; 2 of the studies did not specify the criteria used to identify PIM prescribing in the older popula-tion [31,33]. According to the NOS, the average score of studies was 8.5, which indicates high quality, ranging from 5 to 10 (refer to online suppl.…”

Section: Resultsmentioning

confidence: 99%

“…2. Prevalence of polypharmacy in the older population in Ethiopia [31,[33][34][35][36][37]. CI, confidence interval.…”

Section: Resultsmentioning

confidence: 99%

“…1). There was no heterogeneity between the studies (I 2 = 0.0%) Polymorbidity Three studies demonstrated the relationship between polymorbidity and the risk of PIMs in the older population [31,33,36]. The combined analysis revealed an in- consistent association between the presence of polymorbidity and PIM use (RR: 1.11, 95% CI: 0.31-3.99, p = 0.05), and significant heterogeneity was noticed among studies (I 2 = 82.7%; Fig.…”

Section: Gendermentioning

confidence: 99%

“…3. Prevalence of PIM use in older patients in Ethiopia[32][33][34][35][36]38]. PIM, potentially inappropriate medication; CI, confidence interval.…”

mentioning

confidence: 99%

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Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

2021

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Background and Aim: Polypharmacy and potentially inappropriate medication (PIM) use in older populations (65+ years) have not yet been investigated by meta-analyses in developing countries. This systematic literature review and meta-analysis aimed to investigate the prevalence of polypharmacy and PIM use and major risk factors associated with PIM prescribing in older adults in Ethiopia. Methods: We searched PubMed/MEDLINE, Scopus, Embase, and Google Scholar databases to identify relevant studies published between January 1990 and October 2020. Observational studies reporting the prevalence and association of risk factors with polypharmacy and PIM use in the older population were meta-analyzed. A multilevel meta-analysis was conducted to pool the prevalence estimates, and the risk of PIM use was reported as a relative risk (RR) with a 95% confidence interval (CI). Results: We identified by systematic literature review 404 articles. Of those, 8 studies fulfilled inclusion criteria, comprising a total sample of 2,608 participants. The overall prevalence of polypharmacy and PIM use pooled by meta-analysis in the Ethiopian older population was 33 and 37%, respectively. The risk factors of PIM use were analyzed in the meta-analysis (particularly polymorbidity, polypharmacy, gender, and older age), and only older age of 65+ (RR: 1.71, 95% CI: 1.16–2.51) was significantly associated with PIM use. Conclusion: This first meta-analysis from a developing country revealed a high prevalence of polypharmacy and PIM use in the Ethiopian older population. There was no awareness about the risk of PIMs in patients with polypharmacy and polymorbidity, and older age significantly predicted PIM use. Interventions ensuring rational geriatric pharmacotherapy are essential in developing countries in order to reduce the expected burden of PIM-related geriatric morbidity, higher costs, and mortality.

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Section: Resultsmentioning

confidence: 99%

“…2. Prevalence of polypharmacy in the older population in Ethiopia [31,[33][34][35][36][37]. CI, confidence interval.…”

Section: Resultsmentioning

confidence: 99%

Section: Gendermentioning

confidence: 99%

“…3. Prevalence of PIM use in older patients in Ethiopia[32][33][34][35][36]38]. PIM, potentially inappropriate medication; CI, confidence interval.…”

mentioning

confidence: 99%

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Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

2021

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“…The United Nations (UN) estimated that individuals aged 65 years and older accounted for 3.6% of the Ethiopian population in 2020 and is expected to reach 5.2% by 2050 [ 15 ]. Previous studies have investigated the extent of polypharmacy and PIM use using START/STOPP criteria and Beers criteria [ 16 , 17 , 18 , 19 , 20 , 21 ] and found poor medication-related quality of life among Ethiopian older patients [ 22 ]. Moreover, a recent meta-analysis from Ethiopia reported a high prevalence of PIM use (37%) among the older population [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

et al. 2021

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Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multivariable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.

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Prevalence of polypharmacy among older adults in Ethiopia: a systematic review and meta-analysis

kitaw,

Haile

2023

Sci Rep

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Polypharmacy is a significant concern for older adults. Taking multiple medicines to prevent and treat comorbidities is very common in older adults, potentially leading to polypharmacy. Polypharmacy is associated with the development of geriatric syndromes, including cognitive impairment, delirium, falls, frailty, urinary incontinence, and weight loss. The prevalence of polypharmacy varies according to the literature. There is a paucity of data regarding the prevalence of polypharmacy among older adults. Therefore, this study aimed to estimate the pooled prevalence of polypharmacy among older adults in Ethiopia. A comprehensive search of databases, including PubMed, MEDLINE, EMBASE, Hinari, Cumulative Index to Nursing and Allied Health Literature, International Scientific Indexing, Cochrane library and Web of Science, and Google Scholar, was conducted. STATA statistical software (version 17) was used to analyze the data. Forest plot and I2 heterogeneity test were computed to examine the existence of heterogeneity. Subgroup analysis and sensitivity analysis were done to explore the source of heterogeneity. Publication bias was evaluated by using funnel plots and Egger’s test. A random effect model was used to determine the pooled prevalence of polypharmacy. After reviewing 123 studies, 13 studies with a total of 3547 older adults fulfilled the inclusion criteria and were included in this meta-analysis. The result from 13 studies revealed that the pooled prevalence of polypharmacy among older adults in Ethiopia was 37.10% (95CI: 28.28–45.91). A Subgroup Meta-analysis showed that the heterogeneity level was slightly lower among studies done in Oromia region (I2 = 46.62, P-value = 0.154). Higher pooled polypharmacy prevalence was found among older adults with cardiovascular disorders (42.7%) and admitted patients (51.4%). In general, it was found that the pooled prevalence of polypharmacy among older adults in Ethiopia was high. More than one in three older adults take five or more medications at a time. Thus, intervention focusing on rational geriatric pharmacotherapy is significant to prevent unnecessary pill burden, adverse drug events, medical costs, geriatric morbidity, and mortality. Furthermore, enhancing pharmacist roles towards medication therapy management and safety monitoring in older adults is also indicated.

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Polypharmacy and the Contributing Factors Among Elderly Patients in Shashemene Referral Hospital, West Arsi, Oromia Region, Ethiopia

Cited by 4 publications

References 13 publications

Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

Prevalence of polypharmacy among older adults in Ethiopia: a systematic review and meta-analysis

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