PIH82 PREVALENCE AND PREDICTORS OF POLYPHARMACY AND POTENTIALLY INAPPROPRIATE MEDICATIONS IN A LARGE COMMUNITY-DWELLING OLDER POPULATION IN ITALY

Abstract

To analyze the prevalence of polypharmacy and potentially inappropriate medications (PIMs) in the older population of the Parma Local Health Authority (LHA), Italy, and to evaluate their associations with patients’ and general practitioners’ (GPs) characteristics. Adults 65 years and older were evaluated in a cross-sectional retrospective study using the Parma LHA administrative healthcare data. Subjects were included if they lived in the Parma LHA for the entire year of 2018 and filled at least one medication prescription. Polypharmacy (>5 medications) and excessive polypharmacy (>10 medications) were indicated by adding the total number of medications per quarter, averaged over four quarters. PIMs exposure was defined based on the updated 2017 Maio criteria. Multiple logistic regression models were used to evaluate the associations between polypharmacy and PIMs with patients’ and GPs’ characteristics. Out of 92,146 older patients with a mean age of 76.7 (±7.8), 40% were exposed to polypharmacy, 5% to excessive polypharmacy, and 34% to at least one PIM. Male patients and those ≥75 years old were more likely to be exposed to polypharmacy, excessive polypharmacy, and PIMs. Physicians 60 years and younger were more likely to have patients exposed to polypharmacy and excessive polypharmacy. Male GPs showed greater odds of exposing their older patients to PIMs. Patients with polypharmacy and excessive polypharmacy were more likely to be exposed to PIMs [OR=4.42, 95%CI: 4.25-4.59 and OR=3.73, 95%CI: 3.43-4.05, respectively]. A substantial number of older adults in Parma LHA were exposed to polypharmacy and PIMs. The insight into patients’ and GPs’ characteristics associated with polypharmacy and PIMs may help to enhance the prescribing strategies in this vulnerable patient population.