The prevalence of suboptimal prescribing of medication in First Nations older adults in the Torres Strait

Objectives

This study assessed the prevalence of suboptimal prescribing of medicines in First Nations older adults in the Torres Strait. Types of suboptimal prescribing included polypharmacy, over-prescribing, under-prescribing and anticholinergic burden. It also assessed any significant associations between suboptimal prescribing and common age-related problems such as falls, reduced function and cognition.

Method

Cross-sectional study (2015–2018) on 18 island and five mainland communities in the Torres Strait and Northern Peninsula Area of Far North Queensland, Australia. Community-dwelling residents aged 45 years and older who identified as Torres Strait Islander and/or Aboriginal with complete medication histories were recruited in this study. Validated prescribing tools were used to identify suboptimal prescribing practises.

Results

There were 254 participants with complete medication histories. The mean age was 65.7 (SD ± 10.9, range 45–93), with 65% female. Suboptimal prescribing in this study was 74%. Of these, 49% of participants had polypharmacy, 44% were over-prescribed, and 36% were under-prescribed. Anticholinergic burden was identified in 26% of participants. Polypharmacy was more prevalent in participants who were dependent on instrumental activities of daily living (iADLs).

Conclusions

The results demonstrate the importance of general practitioners, health-care workers or pharmacists, to monitor medication prescribing in this population. Frequent review of medications to reduce suboptimal prescribing practices within these communities may help to reduce adverse outcomes because of prescribing practices.