Researchers are calling for stronger medication reviews after a recent study revealed that older adults, especially women and those with chronic conditions, in Bahrain are likely to receive potentially dangerous prescriptions.
The ‘Potentially inappropriate medications (PIM) for geriatric patients in Bahrain: prevalence, predictors and implications for practice’ study was conducted across 27 primary healthcare centres in Bahrain, and found that more than half of those surveyed were prescribed at least one PIM.
“This study highlights the significant burden of PIM use among older adult patients in Bahrain, with more than half of the participants receiving at least one PIM,” researchers noted in their conclusions.
“These findings underscore the urgent need for targeted interventions, particularly among female patients, those with chronic conditions such as diabetes mellitus (Type 2 diabetes), and patients taking five or more medications.”
The study, published in the peer-reviewed Bio Med Central Geriatrics journal, was conducted by a group of researchers from the Royal College of Surgeons in Ireland – Bahrain, including Mohamed Fadhel Abdulla, Fawaz Eyad Obaid, Osama Sobhi Moaket and Mahmood AbdulJabbar Alawainati.
The study, conducted between March and April 2022, focused on a sample of 595 patients, the majority of whom were female (54.5 per cent). The average age was 71.74 years and 96.3pc of those surveyed were Bahraini.
The most common commorbidities were essential hypertension (67.2pc), hyperlipidaemia or high cholesterol (60.7pc) and diabetes (54.5pc).
The average number of medications taken per patient was approximately 4.72.
“Medication safety is an essential and challenging aspect of patient care that aims to optimise clinical outcomes and reduce adverse drug events – undesirable clinical manifestations that result from medication use and include adverse drug reactions (ADRs) and medication errors,” researchers added.
“As the global older adult population is projected to reach two billion by 2050, a parallel increase in the prevalence of PIMs is expected.
“This high prevalence of PIM is associated with higher hospitalisation rates, higher mortality and morbidity outcomes, and higher costs among older adults.”
Overall, the prevalence of PIMs among older adult patients attending primary care centres in Bahrain was similar to that reported internationally.
The study found that gliclazide, a common oral medication prescribed to diabetes patients, was the most frequently prescribed PIM.
Amongst the adverse effects it can cause are low blood sugar or hypoglycemia, hypertension, dizziness, hyperglycemia or high blood sugar, viral infections and back pain.
“Addressing the issue of PIM requires an approach that combines system-level interventions with individualised patient care,” researchers recommended.
“Regular medication reviews by a multidisciplinary team should be integrated into routine clinical practice, particularly during care transitions such as hospital discharge or admission to long-term care facilities.
“Integrating clinical decision support systems into electronic medical records can further enhance these efforts by providing real-time alerts to prescribers, flagging PIMs, suggesting safer alternatives, and identifying potential drug-drug interactions.”
naman@gdnmedia.bh
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