Polypharmacy and potentially inappropriate medications among elderly patients in the geriatric department at a single-center in China: A retrospective cross-sectional study

Medicine (Baltimore). 2021 Oct 22;100(42):e27494. doi: 10.1097/MD.0000000000027494.

Abstract

The aging of the population has become a worldwide concern, especially in China. Polypharmacy and potentially inappropriate medications (PIMs) are prominent issues in elderly patients. Therefore, the aim of this study was to investigate the prevalence of polypharmacy and PIMs in older inpatients and further to explore the factors associated with PIM use.A retrospective, single-center, cross-sectional study was conducted. A total of 1200 inpatients aged 65 years or older admitted from January 2015 to December 2015 were included. The prevalence of polypharmacy (5-9 medications) and hyperpolypharmacy (10 or more medications) was calculated. The 2019 American Geriatric Society Beers criteria were applied to assess PIMs use. Multivariate logistic regression was used to determine the independent factors of PIM use, while zero-inflated negative binomial regression was performed to evaluate the relationship between polypharmacy and PIM use.The median age of the study population was 76 years (interquartile range = 71-81). The median number of medications was 9 (interquartile range = 7-12). 91.58% of the patients took 5 or more medications simultaneously, and 30.08% of the patients were subjected to one or more PIMs. Spironolactone, furosemide, and zopiclone were the top 3 most frequently encountered PIMs. Hyperpolypharmacy and older age were identified as independent factors associated with PIM use. The risk of PIMs rises with the number of medications prescribed.Polypharmacy and PIM use were common in our study, and the risk of PIM use correlated with an increase in the number of medications already prescribed.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • China / epidemiology
  • Comorbidity
  • Cross-Sectional Studies
  • Drug Interactions
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Inappropriate Prescribing / statistics & numerical data*
  • Kidney Function Tests
  • Length of Stay
  • Logistic Models
  • Male
  • Polypharmacy*
  • Potentially Inappropriate Medication List
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Tertiary Care Centers