Prevalence and predictors of potentially inappropriate medications among elderly patients attending government primary care clinics
Elderly patient may become victims of potentially inappropriate medication (PIM) when their drug interactions and effect of the drug on other underlying diseases are not being properly investigated during follow ups with medical officers. PIM has been defined as medication which are not suitable...
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| Format: | Thesis |
| Language: | English |
| Published: |
2019
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/103834/1/B5%20HEMAH%20HARDBOUND%20-%20IR.pdf http://psasir.upm.edu.my/id/eprint/103834/ |
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| Summary: | Elderly patient may become victims of potentially inappropriate medication (PIM)
when their drug interactions and effect of the drug on other underlying diseases
are not being properly investigated during follow ups with medical officers. PIM
has been defined as medication which are not suitable for patients based on
age, laboratory findings, and medical history which may lead to further
complication of health. Issues on double prescriptions from clinics and hospitals,
lack of communication among doctors in both facilities, patient understanding
and adherence to medication to regimes, unavailability of drugs prescribed by
specialists at primary care and cost are important factors which could contribute
to PIM. Aim of the study is determine prevalence and predictors of PIM among
elderly patients attending government primary care clinics in Seremban district.
Elderly patients aged 60 and above attending health clinics in Seremban district
were recruited in this cross sectional study by using random sampling method.
Elderly patients’ sociodemographic and clinical characteristics were obtained
from patients’ prescriptions and medical database as patients present at
pharmacy to collect medication. Prescribed medications were analysed by using
Screening Tool of Older Persons’ Potentially Inappropriate Prescription
(STOPP) criteria and were identified as PIM if the medication were included in
STOPP with similar description. STOPP is a screening tool to measure
incidences of PIM based on physiological system. Sociodemographic data and
clinical characteristics association with PIM were studied to determine predictors
of PIM. Data analysis was conducted by using IBM Statistical Package for Social
Sciences Software (SPSS) version 22. Chi square method was used to
determine the association among variables. The confidence interval was set at
95% and level of significance as p<0.05. Simple logistic regression was applied
to determine the crude odd ratio and variables with p<0.25 were entered into
multivariate logistic regression model to determine predictors for PIM. Majority
of elderly patients had two types of illnesses (50.4%). Most patients were taking
five medication for their illnesses (24.1%). Elderly patients aged above 70 were more likely to have PIM (AOR=1.721, 95% CI 1.316-1.974) compared to patients
below the age of 70. Patients who were taking more than five prescribed
medication were more likely to have PIM (AOR=1.628, 95% CI 1.152 to 1.850)
compared to patients taking less than 5 prescribed medication. Patient with more
than three number of illnesses were more likely to have PIM compared to
patients with less than three number of illnesses. Patients with endocrine
disease, renal disease and urogenital disease were more likely to have PIM in
their regime compared to patients without the disease. Predictors of PIM based
on this study were age (>70 years) number of prescribed medication (>5),
number of illnesses (>3), endocrine disease, renal disease and urogenital
disease. Prevalence of PIM is found to be high, 37% based on STOPP criteria.
The finding of the study can be used as a baseline study on PIM among elderly
in Malaysia primary care setting. By identifying PIM, many health related issues
and medication errors among elderly patients can be reduced and resolved. |
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