Potentially inappropriate medication use among older patients attending a geriatric centre in south-west Nigeria

Abstract

Objectives:To determine the prevalence and describe factors associated with the use of potentially inappropriate medication (PIM) among older patients.Methods:Cross sectional study of 400 older patients selected systematically at the geriatric centre, University College Hospital, Ibadan between July and September 2016. With the aid of semi-structured questionnaires, information on the socio-demographic characteristics, lifestyle habits, healthcare utilisation and morbidities was obtained. The Beer’s criteria 2015 update was used to identify the PIMs. Predictors of PIMs were determined using multivariate analyses at alpha 0.05.Results:Age was 70.2 (SD=5.9) years and 240 (60%) were females. General prescription pattern showed antihypertensives (34.7%) as the commonest medications used. The point prevalence of PIMs use was 31%. In all, 10 PIMs were used by the respondents. The majority (81.5%) were using one PIM, while (17.7%) used two PIMs and (0.8%) 3 PIMs. NSAIDs (72.6%) were the commonest PIMs identified, followed by the benzodiazepines (24.2%). Respondents had an average of 1.9 morbidities, and mulitmorbidity found in 60.5%. Logistic regression analysis showed self-rated health assessed as better compared with age-mates [OR =1.718 (1.080–2.725)] and being physically active [OR =1.879 (1.026–3.436)] as the most significantly associated with PIMs use.Conclusions:The use of PIMs among older patients in our setting was high with NSAIDs being the most frequently used medications. An interdisciplinary approach, of medication review by pharmacists’, working with physicians may improve prescribing practices among older persons. Therefore, it is necessary to create public health awareness on the use of PIMs among older persons.

A retrospective evaluation of the association between potentially inappropriate prescribing and adverse drug reactions among hospitalized elderly Nigerians

“…A few studies have applied the Beers Criteria to evaluate the quality of medicine prescribing among elderly Nigerians [21][22][23], however, to the best of these authors' knowledge, this was the first study to assess associations between the Beers PIMs and ADRs in this population. This study will, therefore, add to the existing information about the potential adverse effects of medicines among the elderly in Nigeria.…”

“…There is, however, a dearth of information concerning the association between this latest itinerary of the AGS-Beers Criteria and ADRs among the elderly. In Nigeria, studies have applied the Beers Criteria to screen for PIMs without exploring the clinical outcomes associated with the prescription of such medications [21][22][23]. This study aimed to evaluate the prevalence of ADRs and to determine the association between the 2015 AGS-Beers' PIMs and ADRs among hospitalized elderly in Nigeria.…”

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

“…Leslie and Kish formula for single proportion using the prevalence of 31.0% from the study on PIMs use among older Nigerians [20] was used to determine the sample size. Thus, 335 case files of elderly patients at the CTAGC, UCH were selected.…”

“…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].…”

“…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].…”