Medication Consumption Patterns and Polypharmacy among Community-Dwelling Elderly in Lomé (Togo) in 2017

Abstract

Background. In the sub-Saharan African, region of the world with a fast growing aging population and where the use of herbal products is very common, there is a paucity of data on medication consumption patterns among elderly people. The objective of this study was to assess the prevalence of polypharmacy and its associated factors among community-dwelling elderly in Lomé, Togo, in 2017. Methods. A cross-sectional study was conducted from March to June 2017 in Lomé, Togo among people aged 60 years and older. The Respondent Driven Sampling method was used to recruit participants. Data on socio-demographic characteristics and medication consumption patterns, including the use of medicinal plants and dietary supplements, were collected using a standardized questionnaire during a face-to-face interview at participants’ home. Descriptive and binary logistic regression analyses were performed. Results. A total of 370 participants with median age 65 years, (IQR: 62–71) were enrolled in the study. Almost three elderly in five (57.6%) were multimorbid (had two or more chronic diseases). Conventional drugs (78.4%), medicinal plants (14.3%) and other dietary supplements (9.5%) were used by participants. The prevalence of polypharmacy was 22.7% (95% CI: 18.5–27.3%). Concurrent use of conventional drugs and medicinal plants or other dietary supplements was observed among 17.0% of participants and 67.3% reported self-medication. Multimorbidity (aOR = 4.55; 95% CI: [2.42–8.54]) and female sex (aOR = 1.86; 95% CI: [1.00–3.47]) were associated with polypharmacy. Conclusion. One elderly in five uses five or more medications in Togo. Further studies are needed to assess drug-drug interactions and herb-drug interactions among this population.

Anti-Cholinergic Drug Burden Among Ambulatory Elderly Patients in a Nigerian Tertiary Healthcare Facility

“…Elderly patients with higher diagnosis count significantly had more drugs prescribed to them compared to those with less. This observation is in keeping with reports from several other studies where the presence of multiple comorbidities in the elderly patients was a factor associated with higher number of prescribed medicines (Slabaugh et al, 2010;Gbeasor-Komlanvi et al, 2020). Elderly patients with higher number of prescribed drugs were more likely to have drugs with anticholinergic effects prescribed resulting in a higher anticholinergic burden, as revealed by results of this study.…”

“…Polypharmacy was present in more than a third of our study participants; this is similar to a prevalence of 32% obtained in a Brazilian study (Pereira et al, 2017b). Contrarily, a study conducted among the elderly in Togo reported 22% prevalence of polypharmacy, while a pan-European study reported prevalence in range of 26.3-39.9% (Midão et al, 2018;Gbeasor-Komlanvi et al, 2020).…”

“…The population of the elderly continues to grow in Africa and as such we expect medicine-related problems to increase among them. Some research work has been conducted in Nigeria, South Africa, Togo and Ethiopia on medication related issues such as prescription of inappropriate medicines among the elderly (Fadare et al, 2013;Nwani and Isah, 2015;Saka et al, 2018;Tegegn et al, 2019;Gbeasor-Komlanvi et al, 2020). However, there is paucity of information about the use of drugs with anticholinergic effects and anticholinergic drug burden among elderly patients in Sub-Saharan Africa, especially in Nigeria.…”

Prevalence and factors associated with poor self-rated health among community dwelling older adults in Lomé (Togo) in 2019

“…Having two or more chronic diseases was defined as multimorbidity and daily consumption of ≥5 drugs was defined as polypharmacy. 17 …”

Medication-related burden from the perspective of the elderly

“…This population growth carries significant challenges for healthcare systems, as older patients use a significant amount of healthcare resources, which are mostly medications [3]. There are different definitions for polypharmacy including quantitative measures such as the use of multiple medications daily by a patient or consumption of more medicines than clinically indicated [4,5].There are also qualitative measures, including the inappropriate use of medication or unnecessary medicines involving therapeutic duplication, as well as associated terms such as minor, moderate and major polypharmacy [5]. Although there is no universally accepted definition of polypharmacy, it can be described as being appropriate [1].…”