Prevalence of Potentially Inappropriate Medications in Ayder Referral Hospital, Tigray Region, Northern Ethiopia: Prospective Study

Abstract

Background: Potentially inappropriate medication (PIM) use includes the use of drugs with higher risk where adverse drug effect outweighs the clinical benefit, especially when more effective alternative therapy is available. Objective: The aim of this study was to assess prevalence and risk factors associated with the use of PIMs in elderly patients at medical ward of Ayder Referral Hospital (ARH), Tigray region, Northern Ethiopia. Methods: A facility based prospective cross sectional study was conducted among 140 elderly patients from February 6, 2014 to May 05, 2014 in ARH. Patients with age ≥ 60 years admitted to medical ward during the study period were randomly selected. Data were collected with a structured questionnaire and analyzed using statistical package for social science (SPSS, IBM Corporation) version 20. Binary logistic regression was used to analyze factors associated with occurrence of PIM. Results: Of 140 patients, 52.1% were males and forty (28.6%) of patients received at least one potentially inappropriate medication. The most commonly used potential inappropriate medications were metoclopramide (25.58%), nifedipine (16.28%), diazepam (13.95%) and meperedine (13.95%). Above half of (58%) patients encountered polypharmacy. Thirty eight percent of the participants' had comorbid conditions. In the binary logistic analysis, patients with polypharmacy were more likely to receive PIMs [AOR 4.163: 95 % CI 1.75-9.92, p=0.001]. Conclusions: Prevalence of PIMs in elderly patients admitted to ARH was high. Polypharmacy was identified as the independent predicator of the uses of PIMs. Clinical pharmacists' are in a position to alert and monitor the exposure to PIMs as part of multidisciplinary team.

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

“…This study sought to assess the prevalence and determinants of multimorbidity, polypharmacy, and PIM use among older patients attending chronic care clinics in Ethiopia. Overall, the prevalence of multimorbidity and PIM use is becoming increasingly common in Ethiopia, and our findings are in concordance with other studies [ 18 , 19 , 20 , 23 , 24 ]. It was found that around 60% of the older adults had multimorbidity, a quarter of them experienced polypharmacy, and nearly half (47.1%) of them were being treated with at least one PIM during the study period.…”

“…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 ].…”

Potentially inappropriate medication use among older adult patients on follow-up at the chronic care clinic of a specialized teaching hospital in Ethiopia. A cross-sectional study

“…In the Middle East, several studies have reported a high prevalence of PIMU; 57.5% from Saudi Arabia [ 14 ], 62.6 and 76.0% from Qatar [ 15 , 16 ], 59.6% from Lebanon [ 17 ], and 53.1% from Kuwait [ 18 ]. In Africa, one study from Nigeria [ 19 ] reported a 31% PIMU among older adult patients, while studies from Ethiopia revealed a nearly similar magnitude of PIMU; 27.72% from Gondar [ 20 ], 23% from Dessie [ 21 ], and 28.6% from Tigray [ 22 ]. Using STOPP/START, a study from Kuwait [ 18 ] reported at least one PIMU in 55.7%, while in a study from Gondar [ 23 ] PIMU was identified in 61.5% of older adult patients.…”

Potentially inappropriate medication use among elderly patients on follow-up at the chronic care clinic of a specialized teaching hospital in Ethiopia. A cross-sectional study

“…In Middle East, several studies have reported a high prevalence of PIMU; 57.5% from Saudi Arabia (14), 62.6% and 76.0% Qatar (15,16), 59.6% from Lebanon (17), and 53.1% from Kuwait (18). In Africa, one study from Nigeria (19) reported a 31% PIMU among elderly patients, while studies from Ethiopia revealed nearly similar magnitude of PIMU; 27.72% from Gondar (20), 23% from Dessie (21), and 28.6% from Tigray (22). Using STOPP/START, a study from Kuwait (18) reported at least one PIMU in 55.7%, while in a study from Gondar (23) PIMU was identi ed in 61.5% in of elderly patients.…”

“…In Africa, studies are limited. One study from Nigeria (19) reported a 31% of PIMU, while in Ethiopia, studies from Tigray(22); Gondar(20), and Dessie(21) reported PIMU in 28.6% 27.7%, and 23% of the elderly patients, respectively. The discrepancy in the magnitude of PIMU could be due to many factors.…”