Cargando…

Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon

BACKGROUND AND AIMS: Under‐prescription is defined as the exclusion of medications indicated for the treatment of certain conditions without any rationale for not prescribing them. The under‐prescription of medications is highly prevalent among older adults (≥65 years) receiving polypharmacy. This s...

Descripción completa

Detalles Bibliográficos
Autores principales: Hanna, Venise, Chahine, Bahia, Al Souheil, Farah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358532/
https://www.ncbi.nlm.nih.gov/pubmed/35949679
http://dx.doi.org/10.1002/hsr2.759
_version_ 1784763951719907328
author Hanna, Venise
Chahine, Bahia
Al Souheil, Farah
author_facet Hanna, Venise
Chahine, Bahia
Al Souheil, Farah
author_sort Hanna, Venise
collection PubMed
description BACKGROUND AND AIMS: Under‐prescription is defined as the exclusion of medications indicated for the treatment of certain conditions without any rationale for not prescribing them. The under‐prescription of medications is highly prevalent among older adults (≥65 years) receiving polypharmacy. This study aimed to assess the prevalence of the under‐prescription of medications using the Screening Tool to Alert to Right Treatment (START) criteria version 2 and to identify the predictors of having potential prescribing omissions (PPOs). METHODS: This cross‐sectional, face‐to‐face interview study was carried out between September 2021 and February 2022. The study comprised community‐dwelling older adults taking at least one medication on a regular basis. The study questionnaire included the patients' demographics, clinical data, and comorbidities. PPOs were identified using the START criteria. The χ (2) test was used to assess the association between under‐prescription of medication and the demographic/clinical variables. Multivariable logistic regression was performed to explore factors associated with under‐prescription of medications as the dependent variable and taking all variables that showed a p < 0.05 in the bivariate analysis as independent. RESULTS: A total of 444 older adults agreed to participate in this study. The mean age of participants was 71 ± 8.6; the majority of them, 305 (68.7%), were men. Polypharmacy was present in 261 patients (58.8%) and underprescribing of medications in 260 patients (58.6%). The highest percentage of under‐prescribing of medications was reported with statins in 115 patients (44.2%) followed by aspirin in 93 (35.7%), and angiotensin‐converting enzyme inhibitors in 61 (23.4%). The results of the multivariable analysis showed that patients with underprescribed medications had higher odds of polypharmacy (odds ratio [OR]: 2.015, confidence interval [CI] 95% 1.362–2.980, p < 0.001) and higher Charlson Comorbidity Index (OR 2.807, CI 95% 1.463–5.85, p = 0.02). CONCLUSION: The present findings highlight that PPOs are highly prevalent among community‐dwelling older adults in Lebanon. Multimorbidity and polypharmacy were the identified predictors for under‐prescription of medications in this population.
format Online
Article
Text
id pubmed-9358532
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-93585322022-08-09 Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon Hanna, Venise Chahine, Bahia Al Souheil, Farah Health Sci Rep Original Research BACKGROUND AND AIMS: Under‐prescription is defined as the exclusion of medications indicated for the treatment of certain conditions without any rationale for not prescribing them. The under‐prescription of medications is highly prevalent among older adults (≥65 years) receiving polypharmacy. This study aimed to assess the prevalence of the under‐prescription of medications using the Screening Tool to Alert to Right Treatment (START) criteria version 2 and to identify the predictors of having potential prescribing omissions (PPOs). METHODS: This cross‐sectional, face‐to‐face interview study was carried out between September 2021 and February 2022. The study comprised community‐dwelling older adults taking at least one medication on a regular basis. The study questionnaire included the patients' demographics, clinical data, and comorbidities. PPOs were identified using the START criteria. The χ (2) test was used to assess the association between under‐prescription of medication and the demographic/clinical variables. Multivariable logistic regression was performed to explore factors associated with under‐prescription of medications as the dependent variable and taking all variables that showed a p < 0.05 in the bivariate analysis as independent. RESULTS: A total of 444 older adults agreed to participate in this study. The mean age of participants was 71 ± 8.6; the majority of them, 305 (68.7%), were men. Polypharmacy was present in 261 patients (58.8%) and underprescribing of medications in 260 patients (58.6%). The highest percentage of under‐prescribing of medications was reported with statins in 115 patients (44.2%) followed by aspirin in 93 (35.7%), and angiotensin‐converting enzyme inhibitors in 61 (23.4%). The results of the multivariable analysis showed that patients with underprescribed medications had higher odds of polypharmacy (odds ratio [OR]: 2.015, confidence interval [CI] 95% 1.362–2.980, p < 0.001) and higher Charlson Comorbidity Index (OR 2.807, CI 95% 1.463–5.85, p = 0.02). CONCLUSION: The present findings highlight that PPOs are highly prevalent among community‐dwelling older adults in Lebanon. Multimorbidity and polypharmacy were the identified predictors for under‐prescription of medications in this population. John Wiley and Sons Inc. 2022-08-08 /pmc/articles/PMC9358532/ /pubmed/35949679 http://dx.doi.org/10.1002/hsr2.759 Text en © 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Hanna, Venise
Chahine, Bahia
Al Souheil, Farah
Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon
title Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon
title_full Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon
title_fullStr Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon
title_full_unstemmed Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon
title_short Under‐prescription of medications in older adults according to START criteria: A cross‐sectional study in Lebanon
title_sort under‐prescription of medications in older adults according to start criteria: a cross‐sectional study in lebanon
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9358532/
https://www.ncbi.nlm.nih.gov/pubmed/35949679
http://dx.doi.org/10.1002/hsr2.759
work_keys_str_mv AT hannavenise underprescriptionofmedicationsinolderadultsaccordingtostartcriteriaacrosssectionalstudyinlebanon
AT chahinebahia underprescriptionofmedicationsinolderadultsaccordingtostartcriteriaacrosssectionalstudyinlebanon
AT alsouheilfarah underprescriptionofmedicationsinolderadultsaccordingtostartcriteriaacrosssectionalstudyinlebanon