Prevalence, Characteristics and Determinants of Polypharmacy Among Elderly Patients Attending Primary Health Care Centers in Bahrain

Abstract

Objectives: This study aims to determine the prevalence, characteristics and determinants of polypharmacy among elderly patients in Bahrain. Methods: A cross-sectional study was conducted in the period between March and April 2022 in all primary healthcare centres in Bahrain. A simple random sample was obtained. An elderly patient was defined as a patient aged 60 years or above. In addition, polypharmacy was defined as the concomitant use of 5 medications or more and excessive polypharmacy was defined as the concomitant use of 10 medications or more. Results: A total of 977 patients were included, more than half of them were females (n=533, 54.44%) and the mean age of the participants was 67.90 ±6.87 years. Essential hypertension, hyperlipidemia and diabetes mellitus were the most common comorbidities among the participants (61.51%, 57.63% and 53.22%, respectively). Of the cohort, 443 were on 5 or more medications i.e., polypharmacy (45.34%), and around 7% were on at least 10 medications (n=66, 6.76%). A multivariate analysis revealed that patients with diabetes (OR=5.836, CI 4.061-8.385, P<0.001), hypertension (OR=6.231, CI= 4.235-9.168, P<0.001), hyperlipidemia (OR 3.999, 95% CI 2.756-5.802, P<0.001), cardiovascular diseases (OR 3.589, 95 CI 1.787-7.205, P<0.001) and asthma (OR 3.148, 95% CI 1.646-6.019, P<0.001) were significantly more likely to suffer from polypharmacy. Conclusion: Polypharmacy was prevalent among elderly patients in Bahrain, particularly among those with non-communicable diseases. Polypharmacy should be considered while delivering elderly healthcare services, especially in patients with non-communicable diseases. Keywords: Aged, Bahrain, Elderly, Polymorbidity, Polypharmacy.