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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
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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%.