Prevalence and associated factors of potentially inappropriate medication in community-dwelling older adults in china: A meta-analysis^☆

Abstract

Background: With the aging of the population, the prevalence of multimorbidity and polypharmacy is more common among older adults. This increase may heighten the risk of potentially inappropriate medication (PIM), leading to adverse outcomes.
Objective:The study aimed to systematically evaluate the prevalence and associated factors of PIM in community-dwelling Chinese older adults, thereby informing the development of effective intervention strategies.
Methods: In June 2022, an extensive literature review on PIM among community-dwelling Chinese older adults was conducted. This search spanned multiple online databases CNKI, CQVIP, Wanfang Data, SinoMed, PubMed, EmBase, and Web of Science, covering the period from each database's inception to June 2022. Two independent reviewers screened the studies, extracted data, and assessed methodological quality using the quality assessment tool for cross-sectional studies recommended by the Agency for Healthcare Research and Quality. Meta-analysis was performed using Stata 12.0.
Results: 24 studies were included in the analysis, comprising two high-quality and 22 moderate-quality studies. The meta-analysis showed that the prevalence of PIM was 34.8 % (95 %CI = 31.3 %-38.3 %) in community-dwelling older adults in China. Factors associated with PIM were age of 75 years or above (OR [95 %CI] = 1.261 [1.074, 1.481]), having five or more comorbidities (OR [95 %CI] = 3.287 [1.405, 7.691]), and taking five or more medications (OR [95 %CI] = 1.800 [1.305, 2.481]) or 10 or more medications (OR [95 %CI] = 4.380 [2.612, 7.347]).
Conclusion: The prevalence of PIM is considerably high among community-dwelling older adults in China. Key risk factors include older age, multimorbidity and polypharmacy. Therefore, more attention should be paid to the management of medications for older adults exhibiting these characteristics.

Keywords

Potentially inappropriate medication / Older adults / Associated factors / Community health services / Rational medication / Safe medication / Meta-analysis / Evidence-based medicine

Authors' contributions

Conceptualization, L.Y.; Methodology, L.Y.; Data curation, L.Y., K.L, L.Q. and Y.H.; Formal analysis, L.Y., K.L, L.Q. and Y.H; Funding acquisition, K.L.; Project administration, K.L.; Resources, K.L.; Supervision, K.L.; Validation, K.L; Writing—original draft, L.Y.; Writing—review and editing, K.L. All authors have read and agreed to the published version of the manuscript.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Availability of data and materials

Not applicable.

Authors' other information

https://orcid.org/0000-0003-4612-5389 (K.L.).

Funding

This research was supported by grants from the Chongqing Municipal Health Commission and Chongqing Science and Technology Bureau (2021MSXM012).

Declaration of Competing Interests

The authors declare that they have no competing interests

Acknowledgements

Not applicable.

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