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. 2023 Jan 12;16(1):2.
doi: 10.1186/s40545-022-00504-1.

Polypharmacy and potentially inappropriate medications among hospitalized older adults with COVID-19 in Malaysian tertiary hospitals

Chee-Tao Chang  1   2 , Siti Mallissa Mohd Shariff  3 , Nur Suriana Abu Bakar  3 , Nasiha Sufina Ramzuzzaman  3 , Chun Kiat Lim  3 , Eddy Yew Joe Lim  3 , Peng Seng Ong  4 , Jie Min Lee  4 , Aie Yen Tan  5 , Siti Fatimah Kamis  5 , Wei Mun Liew  6 , Yuet Man Low  6 , Doris George  6 , James Yau Hon Voo  7 , Hoo Seng Tan  7 , Philip Rajan  8   9 , Shaun Wen Huey Lee  10
Affiliations

Polypharmacy and potentially inappropriate medications among hospitalized older adults with COVID-19 in Malaysian tertiary hospitals

Chee-Tao Chang et al. J Pharm Policy Pract. .

Abstract

Introduction: Older adults are among the most vulnerable groups during the COVID-19 epidemic, contributing to a large proportion of COVID-19-related death. Medication review and reconciliation by pharmacist can help reduce the number of potentially inappropriate medications but these services were halted during COVID-19.

Aim: To assess the prevalence and factors associated with inappropriate medicine use among older populations with COVID-19.

Methods: This was a cross-sectional, retrospective analysis of medications among hospitalized older adults with COVID-19. Potentially inappropriate medication use was categorized using the Beer's and STOPP criteria.

Results: Combining both criteria, 181 (32.7%) of the 553 patients were identified to have used at least one or more potentially inappropriate medication. A marginally higher number of inappropriate medications was documented using the Beers 2019 criteria (151 PIM in 124 patients) compared to STOPP criteria (133 PIMS in 104 patients). The long-term use of proton pump inhibitors (n = 68; 12.3%) and drugs which increases the risk of postural hypotension were the most commonly reported PIM (n = 41; 7.4%). Potentially inappropriate medication use was associated with previous history of hospital admission in the past 12 months (Odds ratio [OR]: 2.27; 95% CI 1.29-3.99) and higher number of discharge medications.

Conclusions: Nearly, one in three older adults with COVID-19 had been prescribed a PIM, and the proportion of older adults with polypharmacy increased after discharge. This highlights the importance of having clinical pharmacist conducting medication reviews to identify PIMs and ensure medication appropriateness.

Keywords: COVID-19; Hospital; Malaysia; Older adults; Polypharmacy; Potentially inappropriate medications.

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Conflict of interest statement

The authors declare no conflict of interest.

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