الفهرس | Only 14 pages are availabe for public view |
Abstract The current study demonstrated the prevalence of polypharmacy and inappropriate medication use among elderly living in Dar Al-Salam village, Dakahlia governorate; it included 377 elderly people ( ≥ 60 years old), 191 males and 186females. The definition of polypharmacy focusing on the clinical indication of the medication may be more appropriate than the definition focusing on the number of medications. But the best predictor of potential medication interactions was the number of medications used. The study also report the prevalence of some diseases among the population of the study and the most common disease was hypertension 32% (n =122) then diabetes mellitus, chronic liver disease each represent 28% (n =104), and lung diseases 12% (n= 48). The prevalence of polymorbidity (four chronic illnesses or more) was 12 %. The prevalence of polypharmacy (the concurrent use of ≥ five medications) was 56%.The average number of medications was 4.91±3.1. Elderly taking one or more medication represent 89 %. The total number of medication used was (1847 drug), the most common drug groups were, medications use for treatment of alimentary/metabolic diseases represent 35% (n=646) of totally reported medications, followed by cardiovascular medications which represent 25% (n=453), then central nervous system medications which represent 9.5% (n=176). Summary 103 NSAIDS that represents 43.7% of the total OTC medications followed by antacid and H2 blockers that represents16.9%. The most common causes for OTC use were headache, common cold, and musculoskeletal diseases. Polypharmacy was associated with the following risk factors: social factors (house wife, and employee), some chronic illnesses (chronic liver disease, hypertension, stroke, heart failure, and dementia), hospital admission within the last year, and regarding physician visit within the last year Polypharmacy associated with general practitioner, internal medicine, cardiologist, and rheumatologist. Inappropriate medication use present in 41% (n= 155) of the participating elderly. The prevalence of inappropriate medications increased to 51.9% in older people taking five or more medications. Inappropriate medications present in Beers’ table one represent 38% (n=143), while medications present in table two represent only 2.9% (n=12). The most common inappropriate medication was NSAIDS represent 30% of inappropriate medication, followed by gastrointestinal antispasmodic drugs and muscle relaxants, each represents 11.8% then anticholinergics and antihistamines represent 10%. OTC represents 40% of the reported inappropriate medications. Drug interactions among elderly according to Stokley classification were reported in 54 % (n=205) of elderly and increased to 69 % in elderly with polypharmacy, (X) not reported in any case, while (?) interactions represent in 35%, (!) interactions represent in 20%, and (√) interactions represent in 21 % of all the participants. The most common interactions were interaction between two anti diabetics represent 18%, ACEIS + aspirin14%, ACEIS+ digoxin 9.1%, and anti diabetics + ACEIS 6.9%. |