Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia.
Sci Rep. 2023 Oct 17;13(1):17641. doi: 10.1038/s41598-023-45095-2.
Polypharmacy is a significant concern for older adults. Taking multiple medicines to prevent and treat comorbidities is very common in older adults, potentially leading to polypharmacy. Polypharmacy is associated with the development of geriatric syndromes, including cognitive impairment, delirium, falls, frailty, urinary incontinence, and weight loss. The prevalence of polypharmacy varies according to the literature. There is a paucity of data regarding the prevalence of polypharmacy among older adults. Therefore, this study aimed to estimate the pooled prevalence of polypharmacy among older adults in Ethiopia. A comprehensive search of databases, including PubMed, MEDLINE, EMBASE, Hinari, Cumulative Index to Nursing and Allied Health Literature, International Scientific Indexing, Cochrane library and Web of Science, and Google Scholar, was conducted. STATA statistical software (version 17) was used to analyze the data. Forest plot and I heterogeneity test were computed to examine the existence of heterogeneity. Subgroup analysis and sensitivity analysis were done to explore the source of heterogeneity. Publication bias was evaluated by using funnel plots and Egger's test. A random effect model was used to determine the pooled prevalence of polypharmacy. After reviewing 123 studies, 13 studies with a total of 3547 older adults fulfilled the inclusion criteria and were included in this meta-analysis. The result from 13 studies revealed that the pooled prevalence of polypharmacy among older adults in Ethiopia was 37.10% (95CI: 28.28-45.91). A Subgroup Meta-analysis showed that the heterogeneity level was slightly lower among studies done in Oromia region (I2 = 46.62, P-value = 0.154). Higher pooled polypharmacy prevalence was found among older adults with cardiovascular disorders (42.7%) and admitted patients (51.4%). In general, it was found that the pooled prevalence of polypharmacy among older adults in Ethiopia was high. More than one in three older adults take five or more medications at a time. Thus, intervention focusing on rational geriatric pharmacotherapy is significant to prevent unnecessary pill burden, adverse drug events, medical costs, geriatric morbidity, and mortality. Furthermore, enhancing pharmacist roles towards medication therapy management and safety monitoring in older adults is also indicated.
老年人普遍存在多种药物治疗问题。为了预防和治疗多种合并症，老年人同时服用多种药物的情况非常普遍，这可能导致多种药物治疗。多种药物治疗与老年综合征的发展有关，包括认知障碍、谵妄、跌倒、虚弱、尿失禁和体重减轻。多种药物治疗的患病率因文献而异。关于老年人多种药物治疗的患病率，数据很少。因此，本研究旨在估计埃塞俄比亚老年人多种药物治疗的 pooled 患病率。对包括 PubMed、MEDLINE、EMBASE、Hinari、护理和联合健康文献累积索引、国际科学索引、Cochrane 图书馆和 Web of Science 以及 Google Scholar 在内的数据库进行了全面搜索。使用 STATA 统计软件（版本 17）分析数据。计算森林图和 I 异质性检验以检查是否存在异质性。进行亚组分析和敏感性分析以探索异质性的来源。使用漏斗图和 Egger 检验评估发表偏倚。使用随机效应模型确定多种药物治疗的 pooled 患病率。在审查了 123 项研究后，有 13 项研究共纳入了 3547 名老年人，符合纳入标准并纳入了这项荟萃分析。13 项研究的结果表明，埃塞俄比亚老年人多种药物治疗的 pooled 患病率为 37.10%（95CI：28.28-45.91）。亚组荟萃分析表明，在奥罗莫地区进行的研究中，异质性水平略低（I2=46.62，P 值=0.154）。患有心血管疾病（42.7%）和住院患者（51.4%）的老年人中，多种药物治疗的 pooled 患病率较高。总的来说，发现埃塞俄比亚老年人多种药物治疗的 pooled 患病率较高。三分之一以上的老年人一次服用五种或更多药物。因此，关注合理的老年药理学治疗的干预措施对于预防不必要的药物负担、药物不良事件、医疗费用、老年发病率和死亡率非常重要。此外，还需要加强药剂师在老年人药物治疗管理和安全监测方面的作用。
