Evaluation of Polypharmacy in Individuals over 65 Years of Age in Balcova District of Izmir-ShortReport

Year 2023, Volume: 3 Issue: 2, 67 - 71, 29.04.2023

Ozden Gokdemır , Dilek Ersil Soysal , Halil Pak , Melis Kartal Yandım , İlgi Şemin

Abstract

Objectives: The morbidities and long-term multiple medication use among the elderly.
Methods: The study was conducted by the 2nd-grade medical students from Izmir University of Economics under the supervision of instructors. In this descriptive cohort, the study sample included 45 individuals over 65 among the identified 150 residents in Balcova. The response rate was 26.4% for men and 73.3% for women. A questionnaire was defined for a face-to-face interview, which included sociodemographic variables, medical history, lifestyle, systems inquiry, and a detailed list of all medications.
Results: Mean age of the elderly was 78.5 ± 7.2 years. Women, widows, and primary school graduates constituted the majority. Hypertension, osteoarthritis, and osteoporosis were the leading morbidities by 71.1, 46.7 and 31.1%, respectively. Stroke, kidney disease, and migraine were the least morbidities by 3%. 66.7% were using five or more than five medications, 93.3% were using medicines prescribed by the doctor, none complained of adverse effects, 4.4% were non-compliant with treatment, and 28.9% were using vitamin supplements and herbal remedies.
Conclusion: Increase in the prevalence of age-related chronic diseases is accompanied by an increase in polypharmacy,

Keywords

Polypharmacy, elderly, community-based health practice

Project Number

yok

References

• Norbeck TB. Drivers of health care costs. A physicians foundation white paper--first of a three-part series. Mo Med. 2013 Jan-Feb;110(1):30-5.
• OECD (2017), Tackling Wasteful Spending on Health, OECD Publishing, Paris, https://doi.org/10.1787/9789264266414-en.
• Bradley MC, Motterlini N, Padmanabhan S, Cahir C, Williams T, Fahey T, Hughes CM. Potentially inappropriate prescribing among older people in the United Kingdom. BMC Geriatr. 2014 Jun 12;14:72. doi: 10.1186/1471-2318-14-72.
• Hare DL, Toukhsati SR, Johansson P, Jaarsma T. Depression and cardiovascular disease: a clinical review. Eur Heart J. 2014 Jun 1;35(21):1365-72. doi: 10.1093/eurheartj/eht462.
• Genest J, McPherson R, Frohlich J, Anderson T, Campbell N, Carpentier A, Couture P, Dufour R, Fodor G, Francis GA, Grover S, Gupta M, Hegele RA, Lau DC, Leiter L, Lewis GF, Lonn E, Mancini GB, Ng D, Pearson GJ, Sniderman A, Stone JA, Ur E. 2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult - 2009 recommendations. Can J Cardiol. 2009 Oct;25(10):567-79. doi: 10.1016/s0828-282x(09)70715-9.
• World Health Organization (WHO). Ageing and health [Internet]. Vol. 375, WHO. 2021. p. 1–4. Available from: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
• Akici, ahmet, et al. Akilci ilaç kullanimi eğitimi uygulama sürecinde Türkiye’deki tip fakültelerinde farmakoloji anabilim dallarinin durumunun incelenmesi. Tip eğitimi dünyasi, 2011, 29.29: 11-20.
• Rotermann M, Sanmartin C, Hennessy D, Arthur M. Prescription medication use by Canadians aged 6 to 79. Health Rep. 2014 Jun;25(6):3-9.
• Amann U, Schmedt N, Garbe E. Prescribing of potentially inappropriate medications for the elderly: an analysis based on the PRISCUS list. Dtsch Arztebl Int. 2012 Feb;109(5):69-75. doi: 10.3238/arztebl.2012.0069.
• Gressner, A. M.; gressner, O. A. Robert Koch-Institut. In: Lexikon der Medizinischen Laboratoriumsdiagnostik. Berlin, Heidelberg: Springer Berlin Heidelberg, 2019. p. 2078-2079.
• Moore N, Pollack C, Butkerait P. Adverse drug reactions and drug-drug interactions with over-the-counter NSAIDs. Ther Clin Risk Manag. 2015 Jul 15;11:1061-75. doi: 10.2147/TCRM.S79135.
• Tisdale JE, Chung MK, Campbell KB, Hammadah M, Joglar JA, Leclerc J, Rajagopalan B; American Heart Association Clinical Pharmacology Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing. Drug-Induced Arrhythmias: A Scientific Statement From the American Heart Association. Circulation. 2020 Oct 13;142(15):e214-e233. doi: 10.1161/CIR.0000000000000905.
• By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr;67(4):674-694. doi: 10.1111/jgs.15767.
• Emin O. A community pharmacy example in determining inappropiate medicine use in elderly according to beers criteria. İstanbul medipol üniversitesi; 2019. Available from: https://acikerisim.medipol.edu.tr/xmlui/bitstream/handle/20.500.12511/7534/olgun-emin-2019.pdf?sequence=1&isallowed=y
• O'Mahony D, Gallagher PF. Inappropriate prescribing in the older population: need for new criteria. Age Ageing. 2008 Mar;37(2):138-41. doi: 10.1093/ageing/afm189.
• de Souza Silva JE, Santos Souza CA, da Silva TB, Gomes IA, Brito Gde C, de Souza Araújo AA, de Lyra-Júnior DP, da Silva WB, da Silva FA. Use of herbal medicines by elderly patients: A systematic review. Arch Gerontol Geriatr. 2014 Sep-Oct;59(2):227-33. doi: 10.1016/j.archger.2014.06.002.
• Fransen HP, Pelgrom SM, Stewart-Knox B, de Kaste D, Verhagen H. Assessment of health claims, content, and safety of herbal supplements containing Ginkgo biloba. Food Nutr Res. 2010 Sep 30;54. doi: 10.3402/fnr.v54i0.5221.
• Agbabiaka TB, Spencer NH, Khanom S, Goodman C. Prevalence of drug-herb and drug-supplement interactions in older adults: a cross-sectional survey. Br J Gen Pract. 2018 Oct;68(675):e711-e717. doi: 10.3399/bjgp18X699101.
• Colak, M., Gokdemir, O., Yaprak, S., & Kartal, M. Evaluation of home care services at a training and research hospital in Izmir. Marmara Medical Journal, 2016 29(3), 170-176.
• Gökdemir, Ö., Özkan Bayrakçı, N., Aygün, O., & Hoedebecke, K. The perspectives of young general practitioners/family physicians on MOOC as part of continuous education: a descriptive semi-qualitative multinational study. Turkish Journal of Biochemistry, 2021 47(2), 201-207.
• Bhattacharya S, Bera OP, Saleem SM, Hossain MM, Varshney DS, Kaur R, Rana RK, Tripathi S, Gokdemir O, Bacorro M, Mehta K, Singh A. Dietary salt consumption pattern as an antecedent risk factor for hypertension: Status, vision, and future recommendations. Clin Nutr ESPEN. 2022 Feb;47:422-430. doi: 10.1016/j.clnesp.2021.12.006.
• Gökçe Kutsal Y. Polypharmacy in elderly. Turk J Geriatrics. 2006;9(Supplement):37–44.
• Langford, Nigel J., and Anthony Cox. Interactions Between Antihypertensive Drugs and Other Medications. Comprehensive Hypertension. 2007. 1075-1086.
• Elkin N. Yaşlılarda Polifarmasi ve Akılcı İlaç Kullanımına Aile Hekimliği Yaklaşımı. İstanbul Gelişim Üniversitesi Sağlık Bilim Derg. 2020;11(11):279–90.
• López-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L. Anticholinergic Drugs in Geriatric Psychopharmacology. Front Neurosci. 2019 Dec 6;13:1309. doi: 10.3389/fnins.2019.01309.
• Akademik Geriatri Derneği. STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2-TÜRKİYE YAŞLIDA UYGUNSUZ İLAÇ KULLANIM KRİTERLERİ [Internet]. Akademik Geriartri Derneği. 2022. Available from: https://www.akademikgeriatri.org/index.php?func=new_content&id=67
• Dagli RJ, Sharma A. Polypharmacy: a global risk factor for elderly people. J Int Oral Health. 2014 Nov-Dec;6(6):i-ii.