Prevalence of potentially inappropriate prescribing and associated factors among geriatric patients admitted to internal medicine ward in Hawassa comprehensive specialized hospital: Prospective observational study

Abstract

Background Potentially inappropriate prescribing describes use of an indicated drug where the risk outweighs the benefit or when a safer or more effective alternative is available. Potentially Inappropriate prescribing in the geriatric population is considered a public health problem. Potentially inappropriate medication has been associated with multiple adverse consequences. Objective: to assess the prevalence of potentially inappropriate prescribing and associated factors among geriatric patients admitted to internal medicine ward of Hawassa comprehensive specialized hospital. Methods and Materials: Prospective observational study was conducted at internal medicine wards of Hawassa comprehensive specialized hospital. The study was carried out from August 01, 2022 to January30, 2023. All patients who fulfilled the inclusion criteria within the study period were included into this study. STOPP/START tool was used to identify potentially inappropriate medications and omission of medications. Data was first entered to Epidata version 3.1 and analyzed using SPSS version 25. Result: A total of 140 patients with mean age of 63.93 + 4.475 were included. According to STOPP/START version 2 criteria, the prevalence of PIP was 65.7% (92/140). The prevalence of potentially inappropriate medication was 41.43% and potential prescription omission was 24.3%. Of these 21(15 %) of geriatric patients reported hospital readmission and 14.3% had adverse drug reactions. Polypharmacy AOR =5.061 95CI (1.992, 12.855), P=0.002, multimorbidity 3.49 (1.60, 7.59) p=0.002, and monthly income AOR =3.42 95CI= (1.28 - 9.13), P=0.014 were independently associated with potentially inappropriate medications. Multimorbid disease AOR 4.77 (2.02 - 11.26) p=0.002 and length of hospital stay AOR=2.237 CI=0.981-5.102, P=0.05, ADL = 3.195(1.39, 7.32) p=0.006 were statistically significant with potential prescription omission. Conclusion: The prevalence of potentially inappropriate prescribing in elderly patients was high. Multimorbidity was significantly associated with both PIM and PPO. There was no association b/n health related quality of life, ADR with PIM/PPO.