The drug burden index medication use in older people in north-east Nigeria

Abstract

Background and Aims: Evidence has shown that physical and cognitive impairment in older people is linked with the Drug Burden Index (DBI). The study aimed to describe the prescription pattern of DBI medications, estimate the frequency of contraindicated DBI medication use, determine the rate of exposure to high-risk DBI medications, and identify the potential predictors of exposure to high-risk DBI medications.. Methods: This one-year retrospective study was conducted in a secondary healthcare facility. It included patients over 65 years of age who were prescribed at least one anticholinergic and/or sedative medication. The study data were summarized using descriptive statistics, while multivariable logistic regression analysis was used to identify potential predictors of exposure to high-risk DBI medications. Statistically, a significant level was set at p < 0.05. Results: Most patients were exposed to cardiovascular drugs (57.5%) followed by antihistamines (25.8%). A total of 23 (6.3%) contraindicated DBI medications were identified. Sixty (19.6%) older patients were prescribed high-risk DBI medications. Patients over 70 years were 3.08 times significantly more likely to be exposed to high-risk DBI medications. Also, patients with a low number of non-DBI co-medications (adjusted odds ratio [AOR] 3.40, 95% CI 1.03 - 11.23), polypharmacy (AOR 7.38, 95% CI 2.20 – 24.73), and those that had contraindicated DBI medications (AOR 3.93, 95% CI 1.14 – 13.53) were significantly more likely to be exposed to high-risk DBI medications. Conclusion: The study demonstrated that most older people in the study were exposed to anticholinergic medications. A considerable proportion of these older people were exposed to contraindicated and high-risk DBI medications. Patients over 70 years of age, a low number of non-DBI co-medications, polypharmacy, and contraindicated DBI prescriptions were the significant predictors of exposure to high-risk DBI medications.