Clinical Interventions in Aging (Jul 2024)
Potentially Inappropriate Use of Medication and Its Determinants Among Ambulatory Older Adults in Six Community Chain Pharmacies in Asmara, Eritrea: A Cross-Sectional Study Using the 2023 American Geriatric Society Beers Criteria®
Abstract
Saleh Idrisnur,1 Nuru Abdu,2 Filipos Yohannes,3 Tomas Tewelde,4 Natnael Russom,5 Eyasu H Tesfamariam6 1Product Evaluation and Registration Unit, National Medicine and Food Administration, Ministry of Health, Asmara, Eritrea; 2Department of Pharmacy, Adi-Tekelezan Community Hospital, Ministry of Health, Adi-Tekelezan, Eritrea; 3Department of Pharmacy, Ghindae Zonal Referral Hospital, Ministry of Health, Ghindae, Eritrea; 4Gash-Barka Zonal Pharmaceutical Services, Ministry of Health, Barentu, Eritrea; 5Eritrean Pharmacovigilance Center, National Medicine and Food Administration, Ministry of Health, Asmara, Eritrea; 6Biostatistics and Epidemiology, Department of Statistics, College of Sciences, Mai-Nefhi, EritreaCorrespondence: Saleh Idrisnur, Product Evaluation and Regulation Unit, National Medicine and Food Administration, Ministry of Health, Asmara, Eritrea, Tel +291-7455570, Email [email protected]: Potentially inappropriate medication (PIM) use is one of the main drug-related problems encountered in older adults. It is associated with adverse drug events, morbidity, mortality, increased economic costs, and negative effects on the quality of life that requires strict monitoring of prescriptions in older adults. Thus, the study aimed to assess potentially inappropriate medication use and its determinants among older adults.Methods: A cross-sectional study was conducted among all outpatient prescriptions dispensed to older adults (aged 65 years and above) in six community chain pharmacies in Asmara, Eritrea. Data were collected retrospectively, between June 16 and July 16, 2023. PIMs were detected using the 2023 American Geriatric Society (AGS) Beers Criteria®. Descriptive statistics and logistic regression analysis were performed using IBM SPSS® (Version-26.0).Results: A total of 2680 outpatient prescriptions dispensed to older adults were included in this study. The prevalence of PIM among prescriptions was 18.1% (95% CI: 16.7, 19.6). Moreover, a total of 470 medications were found to be avoided in older adults. The most commonly prescribed PIMs were sulfonylureas (27.2%) and substituted alkylamines (16.2%). The prevalence of prescriptions containing medications to be used with caution in older adults was 13.2% (95% CI: 12.0, 14.5). Age (Adjusted Odds Ratio (AOR))=0.98, 95% CI: 0.97, 0.99), polypharmacy (AOR=2.77, 95% CI: 1.49, 5.15), and general practitioner prescriber (AOR=1.38, 95% CI: 1.11, 1.70) were significantly associated with PIMs.Conclusion: A considerable number of ambulatory older adults were exposed to PIMs which require a close attention by policymakers, program managers, and healthcare professionals.Keywords: potentially inappropriate medications, determinants, older adults, AGS Beers Criteria®, community chain pharmacy, Eritrea
