The MGPIDP-L project: Potentially inappropriate drug prescribing and its associated factors

Carmela Bou Malham; Sarah El Khatib; Mathilde Strumia; Sandrine Andrieu; Philippe Cestac; Pascale Salameh

doi:10.1016/j.archger.2023.104947

The MGPIDP-L project: Potentially inappropriate drug prescribing and its associated factors

Arch Gerontol Geriatr. 2023 Jun:109:104947. doi: 10.1016/j.archger.2023.104947. Epub 2023 Jan 28.

Authors

Carmela Bou Malham¹, Sarah El Khatib², Mathilde Strumia³, Sandrine Andrieu⁴, Philippe Cestac³, Pascale Salameh⁵

Affiliations

¹ Aging Research Team, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Paul Sabatier University, Toulouse III, Toulouse F-31073, France. Electronic address: karmela_b_malham@live.com.
² Aging Research Team, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Paul Sabatier University, Toulouse III, Toulouse F-31073, France.
³ Aging Research Team, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Paul Sabatier University, Toulouse III, Toulouse F-31073, France; Department of Pharmacy, Toulouse University Hospitals, Purpan Hospital, Place du Docteur Baylac, TSA 40031, 31059 Toulouse Cedex 9, France.
⁴ Aging Research Team, Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France; Paul Sabatier University, Toulouse III, Toulouse F-31073, France; Department of Clinical Epidemiology and Public Health, CHU Toulouse, F-31059 Toulouse, France.
⁵ School of Medicine, Lebanese American University, Byblos, Lebanon; University of Nicosia Medical School, Nicosia, Cyprus; Faculty of Pharmacy, Lebanese University, Hadath, Lebanon; Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie INSPECT-LB), Beirut, Lebanon.

PMID: 36746016
DOI: 10.1016/j.archger.2023.104947

Abstract

Objective: The aim of this study was to identify the prevalence of potentially inappropriate drug prescribing¹ (PIDP) using a combination of explicit and implicit criteria in a sample of Lebanese older adults taking 5 or more chronic medications per day in ambulatory care settings and to identify which factors were associated with PIDP. The explicit criteria included five different lists: Beers, Laroche, European Union (EU(7)-PIM list), STOPP/ START, STOPP Frail, and Alert and Mastering of Iatrogenesis issued by the French High Authority of Health. We also performed a sensitivity analysis to compare the potentially inappropriate medications according to each criterion.

Methods: Data were collected from each patient via a face-to-face interview. Logistic regressions were conducted to evaluate both objectives.

Results: Many factors were positively associated with PIDP. The risk of PIDP was positively associated with age (OR =4.692, 95% CI [1.889-11.655]). Treatment for insomnia doubled the odds of PIDP (P<0.05). Participants who picked their medications from the pharmacy and had excess stock of drugs were at higher risk of having PIDP by 2.042 (95% CI [1.199-3.478]) and 2.965(95% CI [1.133-7.762]) respectively. However, patients with a perception of being heavily medicated and patients with a missed dose in the last two weeks had lower odds of PIDP.

Conclusion: Our study showed a high prevalence of PIDP in Lebanon, which is associated with various correlates. Selecting the appropriate tools to assess PIDP and providing patient education regarding the risks associated with potentially inappropriate medications are issues to be addressed among older adults.

Keywords: Lebanon; Older adults; Pharmacist; Potentially inappropriate drug prescribing; Primary care; Risk factors.

MeSH terms

Aged
Drug Prescriptions
Humans
Inappropriate Prescribing*
Logistic Models
Potentially Inappropriate Medication List*
Prevalence