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

Abstract

BackgroundWith 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. ObjectiveThe 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. MethodsIn 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. Results24 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]). ConclusionThe 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.