Polypharmacy and Factors Associated With Their Prevalence Among Older Patients Attending a Geriatric Centre in South-West Nigeria

Akande‐Sholabi, Wuraola; Adebusoye, Lawrence A.; Olowookere, O O

doi:10.2139/ssrn.3508232

Cited by 15 publications

(16 citation statements)

References 14 publications

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“…Conversely, the prevalence rate noted in our study is remarkably greater than the rates (23.9%, 29.5%, and 35.7%) recorded in other studies conducted in southwest Nigeria. 19 , 28 , 36 Differences in physicians’ prescribing habits and disease burden may explain the observed discrepancies. Furthermore, varied prevalence rates of polypharmacy among older adults have been observed in different countries.…”

Section: Discussionmentioning

confidence: 99%

Older adults’ exposure to anticholinergic medications: Implications for pharmaceutical care for Nigerian older adults

Okoro

Idris

2022

The Journal of Medicine Access

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Introduction: Anticholinergic medications which are commonly prescribed to older adults can produce more pronounced adverse effects compared to the younger population. Objectives: To investigate the prevalence of polypharmacy, describe the prescription patterns of anticholinergic medications, determine the prevalence of exposure to high-risk anticholinergic cognitive burden (ACB) medications, and identify the potential predictors of exposure to high-risk ACB medications in older adults in a Nigerian secondary hospital. Methods: This cross-sectional study that included older adults prescribed at least one anticholinergic medication was conducted at a secondary care hospital in Nigeria. The study data were initially summarized using descriptive statistics, whereas multivariable logistic regression analysis was used to identify the potential predictors of exposure to high-risk ACB medications. In this study, the cumulative ACB scores were dichotomized into low risk (score 1–2) and high risk (score ⩾ 3). A p value less than 0.05 was considered to be statistically significant. Results: A total of 256 older adults were included in this study; 113 (44.1%) had polypharmacy, whereas 26.6% (188/256) were exposed to high-risk ACB medications. Of a total of 391 anticholinergic medications used by the population, furosemide (36.57%) was the most commonly prescribed. The adjusted multivariable logistic regression analysis indicated that patients who had acute diseases were 2.5 times (adjusted odds ratio (AOR) = 2.49, 95% confidence interval (CI): 1.40–4.45) more likely to be exposed to high-risk ACB medications than those with chronic diseases. Conclusion: The study demonstrates a high prevalence of polypharmacy and exposure to high-risk ACB medications suggesting the need for pharmaceutical care in this high-risk population. Older adults’ exposure to high-risk ACB medications was significantly associated with prescriptions for acute diseases.

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Section: Discussionmentioning

confidence: 99%

Older adults’ exposure to anticholinergic medications: Implications for pharmaceutical care for Nigerian older adults

Okoro

Idris

2022

The Journal of Medicine Access

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“…The rate of polypharmacy is increasing in developing countries like Nigeria due to the growing number of older adults (Tanyi et al 2018). In Nigeria, the number of older individuals taking five or more prescription or over-the-counter medications varies from 25 to 35% (Akande-Sholabi et al 2018a).…”

Section: Introductionmentioning

confidence: 99%

The burden of polypharmacy and potentially inappropriate medication in Nigeria: a clarion call for deprescribing practice

et al. 2022

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Background Polypharmacy and potentially inappropriate medications (PIMs) could cause adverse drug events leading to poor health outcomes. This burden is addressed through deprescribing practice. However, data on deprescribing practices are lacking in Nigeria, where the healthcare systems are fragile. Aim This review aimed to summarise the literature on the burden of polypharmacy and PIMs and identify the need for deprescribing practice in Nigeria. Method A systematic search of the literature was conducted on MEDLINE through PubMed (Public Medline), Google Scholar, and a manual search of included articles to identify information on deprescribing, polypharmacy, and PIMs in Nigeria from the inception of the database to date. Relevant information from the articles was summarised and presented as subsections in the manuscript. Results In this review, we reported the burden of polypharmacy, PIMs, and the need for deprescribing practice in Nigeria. The estimated prevalence of polypharmacy was up to 23.8% among older patients with chronic disorders. Polypharmacy and PIMs have been reported to be a significant cause of medication non-adherence, drug addiction, drug interactions, adverse drug reactions, hospitalisation, morbidity, and mortality. Thus, there is the need to consider deprescription practice in the country. Conclusion This review revealed that polypharmacy and PIMs are common in Nigeria. Therefore, there is a need for deprescribing practice to improve drug safety in the country. This could be achieved through patient education, increasing awareness of deprescribing practice among the healthcare professionals, and ensuring adherence to the core prescribing indicators of the World Health Organization (WHO) and National Standard Treatment Guidelines.

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“…Medications are anticipated to be suitably recommended when they are based on factual scientific indications, usually well-tolerated, and cost-effective [7]. Polypharmacy, although unavoidable in elderly patients its unsafe effects could be decreased by a multi-professional assessment of the patient's circumstance and medications, removal of needless medications, and the utilization of precise and implicit criteria to assess elderly prescriptions [8][9][10]. Numerous criteria have been established to help health care professionals decrease inappropriate prescribing, but the most commonly cited tools are Beers criteria which include of medications the elderly should circumvent irrespective of patient's diagnosis (American Geriatric Society AGS, 2019) [11], and the screening tool of older persons' prescriptions or the screening tools to alert doctors to the right treatment (STOPP/START) criteria [12].…”

Section: Introductionmentioning

confidence: 99%

Beers criteria and potentially inappropriate medications in elderly: awareness, practice, knowledge and barriers among community pharmacists in Nigeria

Akande‐Sholabi

Fafemi

2022

Futur J Pharm Sci

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Background Potential inappropriate medications (PIMs) used in the elderly are an avoidable source of disease and death. Beers Criteria is among the commonly used measures that document PIMs. Community pharmacists’ knowledge on PIMs and existing criteria are essential to moderate the use of PIMs which would enhance overall health outcomes and costs. This study investigates awareness, knowledge, practice, and barriers of PIMs among community pharmacists in Ibadan, Nigeria. Methods A cross-sectional study was carried out on 109 community pharmacists with the use of a self-administered questionnaire. Nine clinical vignettes based on the 2019 Beers Criteria were used to evaluate PIMs knowledge. Practice behavior regarding elderly clients was evaluated using a 5-point Likert scale with six items. Data were summarized by descriptive and inferential statistics. Results Respondents who knew guidelines that listed specific PIMs were (49; 47.1%), and of these, (21; 42.9%) were aware of Beers Criteria. From all the respondents, only 45 (41.3%) demonstrated good knowledge of Beers Criteria, while 82 (75.2%) narrated good practice when dealing with elderly clients in terms of asking suitable questions and contemplating their ages while dispensing medications. Major barrier identified was lack of knowledge of Beers Criteria (80; 73.4%). Pharmacists who were aware of Beers Criteria statistically had better knowledge than others (p = 0.003). Conclusion Beers Criteria awareness among community pharmacists is sub-optimal in Ibadan, Nigeria. Although practice when dealing with elderly customers was satisfactory, the knowledge was unsatisfactory. This underscores the need to intensify the awareness and use of guidelines that document specific PIMs such as Beers Criteria among community pharmacists.

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Polypharmacy and Factors Associated With Their Prevalence Among Older Patients Attending a Geriatric Centre in South-West Nigeria

Cited by 15 publications

References 14 publications

Older adults’ exposure to anticholinergic medications: Implications for pharmaceutical care for Nigerian older adults

Older adults’ exposure to anticholinergic medications: Implications for pharmaceutical care for Nigerian older adults

The burden of polypharmacy and potentially inappropriate medication in Nigeria: a clarion call for deprescribing practice

Beers criteria and potentially inappropriate medications in elderly: awareness, practice, knowledge and barriers among community pharmacists in Nigeria

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