Potential inappropriate prescribing and associated factors among older persons in Nigeria and South Africa

Saka, Sule A.; Oosthuizen, Frasia; Nlooto, Manimbulu

doi:10.1007/s11096-018-0770-1

Cited by 16 publications

(37 citation statements)

References 26 publications

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“…The findings of the PIMs according to Beers criteria in this study were higher compared with the results of previous studies where the prevalence of PIMs were 18.3% and 19.1% in Ireland and Taiwan, respectively [9,24]. But lower when compared with other similar studies conducted in Nigeria where PIMs prevalence ranged from 30.3% to 35.2% [19,21]. Different study environments and awareness of available guidelines by physicians for PIMs may account for these variations.…”

Section: Resultscontrasting

confidence: 89%

“…The presence of multimorbidity warrants the needs of more medications to be used to cure or alleviate the symptoms of the various diseases. Comparable studies carried out in other centres in Nigeria and South Africa also stated > 4 average medications were used per elderly patient [20,21]. Polypharmacy was found to be significantly associated with the use of PIMs in this study, this has also been documented by previous study.…”

Section: Resultssupporting

confidence: 87%

“…Non-steroidal anti-inflammatory drugs are readily available and are the most affordable analgesics in Nigeria. A systematic review by Guaraldo et al, [25] on inappropriate prescribing, reported that amitriptyline, propoxyphene and cyclobenzaprine were among the top inappropriate medications used; [25], while a Spanish and Nigerian study found benzodiazepines and NSAIDs as the most utilized inappropriate medications [20,21,26]. NSAIDs when used for a long duration without gastroprotective agents, or as first line treatment for the management of pain and in the presence of underlying comorbidities such as congestive heart failure, chronic kidney disease and peptic ulcer in the elderly are classified as PIM [11].…”

Section: Resultsmentioning

confidence: 99%

“…Likewise, STOPP criteria, invented and validated in European countries is also used to detect PIMs but based on the physiological systems, considering drug-disease and drug-drug interactions, dose and duration of treatments [12,13]. Several studies employing the use of both criteria have reported the presence of PIMs among elderly patients in Europe 42.1-75.4% [15] , in Qatar 38.2% [16] , in Brazil 29.9-39.6% [17] in Saudi Arabia 37.5%-57.6% [18] and in Nigeria 15.7-45.6% [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

“…In Nigeria, there are few studies that have investigated PIP or the use of potential inappropriate medications among the elderly. These studies revealed PIP as a common occurrence among them [19][20][21][22]. However, some of these studies utilized Beers criteria alone [20][21][22], while some other compared Beers criteria with STOPP [19].…”

Section: Introductionmentioning

confidence: 99%

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Inappropriate prescribing among ambulatory elderly patients in a geriatric centre in Southwestern Nigeria

Akande‐Sholabi

Ajilore

Showande

et al. 2019

Preprint

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Background: Inappropriate medication prescribing is a common, major global health concern among the elderly. There are no guidelines to detect potentially inappropriate prescribing in Nigeria among the elderly. Therefore, this study compared the appropriateness of Beers' and Screening Tool of Older Person’s Prescription (STOPP)/ Screening Tool to Alert Right Treatment (START) criteria to identify potentially inappropriate prescribing in ambulatory elderly patients in Nigeria. Methods: A retrospective study at the geriatric centre, University College Hospital, Ibadan was conducted using systematically selected case files of 335 elderly patients aged ≥ 60 years between 1st January and 31st December 2016. With the aid of a data extraction sheet, information on the socio-demographic characteristics, drug utilisation pattern and morbidities were obtained from the most recent prescription in the case files. The 2015 American Geriatrics Society (AGS)-Beers Criteria, and version 2 of the STOPP and START were subsequently used to identify the Potentially Inappropriate Prescribing (PIP) and Potential Prescribing Omissions (PPOs). Associations between polypharmacy (≥ 5 medications) and multimorbidity (presence of 2 or more diseases), and AGS Beers and STOPP/START criteria were determined with Chi-square test at p <0.05. Results: Mean age of patients was 69 ± 0.4 years (range 60-85 years) and 219 (65.4%) were females. An average of 4.2 medications per patient prescription was found. The Beers criteria identified 26.5% PIMs, while STOPP criteria identified 57.1% PIMs. START detected 29 PPOs in 15 (4.4%) of the patient’s prescription. The most prevalent disease conditions were hypertension 235 (70.1%) and osteoarthritis 64 (19.3%). Polypharmacy was significantly associated with PIMs use in both Beers (p=0.002) and STOPP (p=0.001) criteria. Conclusions: The prevalence of PIP is high among the elderly patients. The STOPP/START criteria identified a higher proportion of PIMs among elderly patients compared with Beers criteria. The frequency of PIP should stimulate efforts to curtail potentially inappropriate prescribing and may require the need for advocating for a national criteria to be adopted by health care professionals in Nigeria. Keywords: Inappropriate prescribing, Beers’ criteria, STOPP/START criteria, Elderly, Nigeria

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Section: Resultscontrasting

confidence: 89%

Section: Resultssupporting

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Inappropriate prescribing among ambulatory elderly patients in a geriatric centre in Southwestern Nigeria

Akande‐Sholabi

Ajilore

Showande

et al. 2019

Preprint

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Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

Tian,

Chen,

Zeng

et al. 2023

JAMA Netw Open

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ImportanceThe use of potentially inappropriate medications (PIMs) is widespread yet continues to receive little attention in outpatient services.ObjectiveTo estimate the overall prevalence of PIM use in outpatient services.Data SourcesPubMed, Embase, and Web of Science were searched to identify relevant studies published from January 1, 1990, to November 21, 2022.Study SelectionObservational studies that reported the prevalence of PIM use among older patients in outpatient services were screened.Data Extraction and SynthesisTwo reviewers independently selected eligible articles, extracted data, and assessed the risk of bias. A random-effects meta-analysis was conducted to pool the prevalence estimates.Main Outcomes and MeasuresThe global patterns in the prevalence of PIM use among older patients in outpatient services were estimated, and the temporal trends and regional differences in PIM use were investigated.ResultsA total of 94 articles with 132 prevalence estimates were analyzed, including nearly 371.2 million older participants from 17 countries. Overall, the pooled prevalence of PIM use was 36.7% (95% CI, 33.4%-40.0%). Africa had the highest prevalence of PIM use (47.0%; 95% CI, 34.7%-59.4%), followed by South America (46.9%; 95% CI, 35.1%-58.9%), Asia (37.2%; 95% CI, 32.4%-42.2%), Europe (35.0%; 95% CI, 28.5%-41.8%), North America (29.0%; 95% CI, 22.1%-36.3%), and Oceania (23.6%; 95% CI, 18.8%-28.8%). In addition, the prevalence of PIM use is highest in low-income areas. Use of PIMs among older patients has become increasingly prevalent in the past 2 decades.Conclusions and RelevanceThis study of patterns of PIM use by different groups, such as geographic regions and World Bank countries, suggests noticeable geographic environment and economic income differences in the burden of PIMs in outpatient services. Furthermore, the high prevalence trend in the past 2 decades indicates that the global burden of PIM use continues to be worthy of attention.

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Risk factors for potentially inappropriate medication use in older adults: a cohort study

et al. 2022

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Potential inappropriate prescribing and associated factors among older persons in Nigeria and South Africa

Cited by 16 publications

References 26 publications

Inappropriate prescribing among ambulatory elderly patients in a geriatric centre in Southwestern Nigeria

Inappropriate prescribing among ambulatory elderly patients in a geriatric centre in Southwestern Nigeria

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

Risk factors for potentially inappropriate medication use in older adults: a cohort study

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