Potentially Inappropriate Medications among Elderly with Frailty in a Tertiary Care Academic Medical Centre in Saudi Arabia

Abstract

This study aims to assess the prevalence of potentially inappropriate medications (PIMs) and to analyze the relationship between the PIMs and frailty among inpatient older adults aged 65 and above in Saudi Arabia. A retrospective cross-sectional study design was utilized during the period between April 2021 and April 2022 of all patients aged 65 years and above admitted in a public tertiary hospital in Saudi Arabia. Data on the number of medications and the use of PIMs were assessed using Beers’ criteria while the frailty status was assessed using the “FRAIL Scale”. Of the 358 patient files that were reviewed, 52.2% were males, 60.9% were aged 65–74 years, and 82% were married. The prevalence of robust, prefrail, and frail patients was 5%, 36.9%, and 58.1%, respectively. According to the 2019 Beers criteria, a total of 45.8% (n= 164) participants identified as using PIMs. Compared to the non-PIMs group, the PIMs group demonstrated significant differences in the number of medications (p < 0.001), the number of comorbidities (p < 0.05), and the frailty score (p < 0.001). The strongest predictor of PIM use was a number of comorbidities, recording an odds ratio of 2.86, (95% CI 1.21–6.77, p < 0.05). Our results show that the use of PIM was significantly associated with frail older adults with multiple comorbidities and in patients with polypharmacy. A clear assessment and evaluation tool may improve the quality of drug treatment in the older adult population, particularly in frail patients.

The current view of potentially inappropriate medications (PIMs) among older adults in Saudi Arabia: a systematic review

“…Consequently, the final number of studies included in this systematic review amounted to 8, as indicated in Figure 2. (Al-Omar et al, 2013;Jastaniah et al, 2018;Alhawassi et al, 2019;Alturki et al, 2020;Alsaad et al, 2022;Alwhaibi, 2022;Alharbi et al, 2022;Jabri et al, 2023).…”

“…This highlights the need for further research efforts to explore such phenomena in more depth. Additionally, it is noteworthy that 6 out of the included studies (constituting 75%) (Al-Omar et al, 2013;Alhawassi et al, 2019;Alturki et al, 2020;Alsaad et al, 2022;Alwhaibi, 2022;Jabri et al, 2023) focused on the elderly population, typically defined as individuals aged 65 years or older the standard definition of elderly in the US or United Kingdom studies. The two remaining studies (Alharbi et al, 2022;Jastaniah et al, 2018) considered a broader age category of 60 years or older, a specification more relevant to the region due to economic, life expectancy, retirement age, and health-related distinctions between the Saudi population and older adult populations in the United Kingdom or US.…”

“…Regarding the study locations, the majority, 6 out of 8 (75%) of the included studies, were carried out in the capital city, Riyadh (Central Region). (Al-Omar et al, 2013;Alhawassi et al, 2019;Alturki et al, 2020;Alsaad et al, 2022;Alwhaibi, 2022;Jabri et al, 2023). One study was conducted in Jeddah (Western Saudi Arabia) (Jastaniah et al, 2018), and the last one took place in Buraidah City (Alharbi et al), also situated in the Central Region.…”

“…One study was conducted in Jeddah (Western Saudi Arabia) (Jastaniah et al, 2018), and the last one took place in Buraidah City (Alharbi et al), also situated in the Central Region. Table 1 (Al-Omar et al, 2013;Jastaniah et al, 2018;Alturki et al, 2020;Saqlain et al, 2020a;Alsaad et al, 2022;Alwhaibi, 2022;Alharbi et al, 2022;Jabri et al, 2023).…”

“…The majority of the studies included in the analysis, specifically 6 out of 8 (constituting 75%) (Al-Omar et al, 2013;Alhawassi et al, 2019;Alturki et al, 2020;Alsaad et al, 2022;Alwhaibi, 2022;Jabri et al, 2023), adopted a cross-sectional study design. The remaining 2 studies (Alharbi et al, 2022;Jastaniah et al, 2018), on the other hand, followed a retrospective cohort study design.…”