Prevalence of Inappropriate Medication Use, Polypharmacy and Study of Medication Adherence among Patients with Diabetes Mellitus in the Geriatric Population

Abstract

Introduction: Diabetes mellitus (DM) is one of the most common lifelong condition causing significant morbidity and mortality particularly in the elderly population. Among the most serious issues in diabetic elderly patients are the very high rate of polypharmacy, misuse of drugs and medication adherence resulting in drug side effects, reduced quality of life and escalated health care costs.

Objectives: This study aims to find the prevalence of inappropriate medication use, polypharmacy, and medication adherence among elderly diabetic patients.

Methods: A six-month cross-sectional observational study was done at a tertiary care hospital among patients of 60 years and above who had diabetes mellitus. Information about demographics, clinical, comorbidity and medications were collected through a structured questionnaire. Inappropriate drug prescribing was evaluated by the Beers Criteria. We also used the Morisky Medication Adherence Scale to measure medication adherence in our patients.

Results: The study had 218 patients with a mean age of 68 years. Polypharmacy was seen in 90.34% of the subjects and inappropriate use of drugs in 34.4% of the subjects. Nonadherence to medication was seen in 58% of the patients, among which significant predictors were comorbidities, complexity of the regimen, and absence of education in managing diabetes. The majority of the patients were on combined medications, and some of the problems concerned probable drug-drug interaction.

Conclusions: Inappropriate drug use and polypharmacy are significantly prevalent among elderly DM patients, thus prescription practices and patient education on well-prescription need to be enhanced. The above patients should receive systematic multidisciplinary treatment and drug review in order to promote compliance and maximize therapeutic benefits.