Assessment of potentially inappropriate medications among long-stay older adult patients with serious mental illnesses: findings from a low-resource setting

Abstract

Background: Potentially inappropriate medications (PIMs) are defined as drugs whose adverse effects outweigh the benefits or when more efficacious alternatives are present. This study aims to assess the overall prevalence of PIMs according to Beers 2019 and 2023 among older adult patients with serious mental illnesses (such as schizophrenia), and factors associated with PIMs while examining the difference between the two versions. Method: This cross-sectional study included chronic patients aged 65 years and above, hospitalized at the Psychiatric Hospital of the Cross (Lebanon), and taking at least one medication daily. Sociodemographic characteristics, medications, and clinical information were obtained from patients’ medical records. SPSS version 26 was used for data analysis. Descriptive statistics were used to describe independent variables, while bivariate analysis was used to assess associations between PIM use and different factors. A two-tailed p value < 0.05 was considered statistically significant. Results: Ninety-seven patients were included with a mean age of 71.21 (± 4.63) years. 52.6% were female. 44.3% were on polypharmacy (5–9 medications). 97.9% had at least one PIM according to both versions with the majority being anticholinergics (84.5%). Polypharmacy was significantly correlated to PIM use. Hospital stay length and the presence of comorbid neurological disorders were negatively associated with PIM use. Conclusion: PIMs were extremely prevalent among hospitalized psychiatric older adult patients. Raising awareness among physicians on the Beers criteria or making them mandatory could help diminish PIM use among this vulnerable population.