Polypharmacy and Potentially Inappropriate Medication Use in Elderly Patients: A Cross-Sectional Study in Family Practice

Abstract

Background:
Polypharmacy and the use of potentially inappropriate medications (PIMs) are growing concerns in geriatric care, contributing to adverse drug events, hospitalizations, and reduced quality of life. In primary care, these issues are particularly critical due to the high burden of chronic illness among elderly patients.

Objectives:
To assess the prevalence of polypharmacy and PIMs use among elderly patients attending family practice clinics and identify associated sociodemographic and clinical factors.

Methods:
A cross-sectional study was conducted at the primary health care centers at Alahsa region , Saudi Arabia, involving 160 elderly patients aged ≥65 years. Data were collected through interviews and electronic medical record reviews. Polypharmacy was defined as the use of ≥5 medications. PIMs were identified using the 2023 AGS Beers Criteria. Descriptive statistics, bivariate analysis, and multivariate logistic regression were performed using SPSS version 26.0.

Results:
Polypharmacy was present in 64.4% of patients, while 40.6% received at least one PIMs. Benzodiazepines, nonsteroidal anti-inflammatory drugs )NSAIDs( and anticholinergics were the most common PIMs. Polypharmacy and age ≥75 years were significantly associated with PIMs use (p < 0.05). Polypharmacy independently predicted PIMs use (OR = 4.36, 95% CI: 2.05–9.28).

Conclusion:
Polypharmacy and PIMs use are prevalent among elderly patients in primary care. Age, multimorbidity, and low education levels contribute to these patterns. Routine medication review and targeted deprescribing interventions are essential for enhancing medication safety in older adults.