Associated factors of potentially inappropriate medications use in elderly patients at the Family Medicine Clinic, Nakornping Hospital

Abstract

Introduction: Potentially inappropriate medications (PIMs) use in older adults is an important issue worldwide, as older patients commonly have multiple comorbidities, receive several medications, and increased risk of adverse drug reactions and drug–drug interactions.

Objective: To identify associated factors of potentially inappropriate medications used in elderly patients at the Family Medicine Clinic, Nakornping Hospital Chiang Mai.

Methods: This cross-sectional study included all patients aged ≥60 years who received at least one prescribed medication from the Family Medicine Clinic at Nakornping Hospital between 1 January and 31 August 2024. Data were obtained from electronic medical records, including demographics, comorbidities, insurance type, prescription details, and laboratory results. PIMs were classified according to the 2023 AGS Beers Criteria. Factors associated with PIM use were analyzed using multiple logistic regression.

Results: Among 134 participants (60.45% female; mean age 71.61 ± 8.56 years), 74.63% had universal coverage insurance, 69.40% had polypharmacy, and 53.73% had ≥2 comorbidities. Overall, 104 (77.61%) received at least one PIMs. Significant factors associated with PIMs use were receipt of ≥ 5 medications (aOR 5.91, 95% CI 1.57–22.27), universal coverage health insurance (adjusted OR 4.83, 95% CI 1.60–14.57), and musculoskeletal disease (adjusted OR 6.98, 95% CI 1.94–25.08). The five most frequently prescribed PIMs were orphenadrine, omeprazole, naproxen, lorazepam, and aspirin, respectively.

Conclusion: PIMs used among older adults in this setting was high. Universal coverage health insurance, polypharmacy (≥ 5 medications), and musculoskeletal disease were significantly associated with PIMs use.