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. 2021 Feb 25;14(3):187.
doi: 10.3390/ph14030187.

Prevalence of Drug-Related Problems and Complementary and Alternative Medicine Use in Malaysia: A Systematic Review and Meta-Analysis of 37,249 Older Adults

Chee-Tao Chang  1 , Ju-Ying Ang  1 , Md Asiful Islam  2 , Huan-Keat Chan  3 , Wee-Kooi Cheah  4   5 , Siew Hua Gan  6
Affiliations

Prevalence of Drug-Related Problems and Complementary and Alternative Medicine Use in Malaysia: A Systematic Review and Meta-Analysis of 37,249 Older Adults

Chee-Tao Chang et al. Pharmaceuticals (Basel). .

Abstract

Drug-related problems (DRPs) in the elderly include polypharmacy, potentially inappropriate medications, nonadherence, and drug-related falls. In this systematic review and meta-analysis, the prevalence of DRPs and complementary and alternative medicine (CAM) use among the Malaysian elderly was estimated. PubMed, Scopus, Web of Science, and Google Scholar databases were searched to identify studies published since their inception up to 24 August 2020. A random-effects model was used to generate the pooled prevalence of DRPs along with its corresponding 95% confidence interval (CI). The heterogeneity of the results was estimated using the I2 statistics, and Cochran's Q test and sensitivity analyses were performed to confirm the robustness of the results. We identified 526 studies, 23 of which were included in the meta-analysis. (n = 29,342). The pooled prevalence of DRPs among Malaysian elderly was as follows: (1) polypharmacy: 49.5% [95% CI: 20.5-78.6], (2) potentially inappropriate medications: 28.9% [95% CI: 25.4-32.3], (3) nonadherence to medications: 60.6% [95% CI: 50.2-70.9], and (4) medication-related falls 39.3% [95% CI: 0.0-80.8]. Approximately one in two Malaysian elderly used CAM. The prevalence of polypharmacy and potentially inappropriate medications among the Malaysian elderly population was high, calling for measures and evidence-based guidelines to ensure the safe medication use.

Keywords: complementary medicine; falls; medication adherence; older adults; polypharmacy; potentially inappropriate medications.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection.
Figure 2
Figure 2
Prevalence of (A) polypharmacy, (B) potentially inappropriate medications, (C) potentially inappropriate prescribing, (D) medical adherence, (E) medication-related falls, (F) potential prescribing omission, and (G) use of complementary and alternative medicines among elderly individuals in Malaysia.
Figure 2
Figure 2
Prevalence of (A) polypharmacy, (B) potentially inappropriate medications, (C) potentially inappropriate prescribing, (D) medical adherence, (E) medication-related falls, (F) potential prescribing omission, and (G) use of complementary and alternative medicines among elderly individuals in Malaysia.
Figure 3
Figure 3
Funnel plot representing the prevalence of polypharmacy among elderly individuals in Malaysia showing no significant publication bias.
See this image and copyright information in PMC

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