Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients:: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

Akshaya Srikanth Bhagavathula; Mohammed Assen Seid; Aynishet Adane; Eyob Alemayehu Gebreyohannes; Jovana Brkic; Daniela Fialová

doi:10.3390/ph14090844

Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

Akshaya Srikanth Bhagavathula^* (Corresponding Author), Mohammed Assen Seid, Aynishet Adane, Eyob Alemayehu Gebreyohannes, Jovana Brkic, Daniela Fialová

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

3 Downloads (Pure)

Abstract

Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multi-variable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.

Original language	English
Article number	844
Number of pages	12
Journal	Pharmaceuticals
Volume	14
Issue number	9
Early online date	25 Aug 2021
DOIs	https://doi.org/10.3390/ph14090844
Publication status	Published - 1 Sept 2021

Bibliographical note

Funding Information:
have received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No. 764632. Research work of . D. Fialová has also been supported by the INOMED project NO.CZ.02.1.01/0.0/0.0/18_069/0010046 co-financed by the European Union, Progress Q42 at the Faculty of Pharmacy, Charles University (KSKF-research group 2, chaired by Assoc. Prof. D. Fialová), START/MED/093 CZ.02.2.69/0.0/0.0/19_073/0016935, SVV260 551 and I-CARE4OLD H2020 -965341.

Acknowledgments:
The authors would like to thank the Research Assistants, University of Gondar and Gondar University Hospital, for their administrative and technical support in fulfilling the EuroAgeism H2020 ESR7 project data collection in Ethiopia.

Data Availability Statement

Data is contained within the article.

Keywords

2019 Beers criteria
Chronic
Determinants
Ethiopia
Multimorbidity
Older adults
Outpatient
Polypharmacy
Potentially inappropriate medication use
Prevalence

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia. / Bhagavathula, Akshaya Srikanth (Corresponding Author); Seid, Mohammed Assen; Adane, Aynishet et al.
In: Pharmaceuticals, Vol. 14, No. 9, 844, 01.09.2021.

Research output: Contribution to journal › Article › peer-review

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abstract = "Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multi-variable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.",

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note = "Funding Information: have received funding from the European Union{\textquoteright}s Horizon 2020 research and innovation program under the Marie Sk{\l}odowska-Curie grant agreement No. 764632. Research work of . D. Fialov{\'a} has also been supported by the INOMED project NO.CZ.02.1.01/0.0/0.0/18_069/0010046 co-financed by the European Union, Progress Q42 at the Faculty of Pharmacy, Charles University (KSKF-research group 2, chaired by Assoc. Prof. D. Fialov{\'a}), START/MED/093 CZ.02.2.69/0.0/0.0/19_073/0016935, SVV260 551 and I-CARE4OLD H2020 -965341. Acknowledgments: The authors would like to thank the Research Assistants, University of Gondar and Gondar University Hospital, for their administrative and technical support in fulfilling the EuroAgeism H2020 ESR7 project data collection in Ethiopia. ",

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