Association between potentially inappropriate prescribing, polypharmacy, and functional/cognitive impairment among Egyptian geriatric patients

Abstract

Background and aims. Potentially inappropriate medications (PIM) use is common among seniors and could be related to various geriatric syndromes. The objective was to determine association between PIM use, polypharmacy, and functional/cognitive impairment among Egyptian geriatric patients. Methods. A cross-sectional study included 251 older adults (aged ≥ 60 years), admitted at the geriatrics hospital of Ain Shams University, Egypt, between March and September 2022. Patients underwent taking of the medical history including age, sex, chronic diseases, geriatric syndromes, pre-hospitalization medications intake, and geriatric assessment; functional status by activities of daily living (ADL) and instrumental activities of daily living (IADL) and cognitive status by mini-mental state examination (MMSE). Multi-morbidity assessed by charlson comorbidity index (CCI). Polypharmacy identified as receiving ≥ 5 medications daily. PIM use defined by the American Geriatrics Society Beers criteria-2019 (AGS Beers criteria-2019). Logistic regression and Pearson correlation were applied. Results. PIM use occurred in 126 (50.2%) patients. Polypharmacy, CCI, having diabetes mellitus, hypertension and a cardiac disease had significant association with PIM use. Polypharmacy (OR 5.514; 95% CI: 2.776-10.952; P.000) and having a cardiac disease (OR 2.359; 95% CI: 1.239-4.490; P. 009) were independent predictors of PIM use. Number of PIM use had a significant negative correlation with MMSE scores. Use of diuretics, proton-pump inhibitors (PPIs) and digoxin were the most frequent PIM. Conclusions. Polypharmacy and having a cardiac disease were predictors of PIM use. The total number of the used PIM negatively correlated with MMSE scores. Medications review and de-prescribing are essential for geriatric patients.