Background: Polypharmacy and potentially inappropriate medications (PIMs) increase the risk of adverse drug events (ADE), which could be fatal in the elderly. This study investigated the prevalence and factors associated with polypharmacy and PIMs among elderly stroke patients in Indonesia.
Method: A cross-sectional study was conducted among stroke patients aged >60 years admitted to Universitas Airlangga Hospital during March 2023 – February 2024. Polypharmacy was defined as five or more medications, and PIMs were measured using the 2023 American Geriatrics Society Beers Criteria®.
Results: A total of 409 patients (mean age: 68.3 years, 49.1% female) were included. The prevalence (95% confidence interval [CI]) of polypharmacy was 84.4% (80.9–87.8). About 84.6% (80.9–88.0) of patients were prescribed at least one PIM, while 50.6% (46.0–55.5) and 25.7% (21.3–29.8) received two and three or more PIMs, respectively. Multivariate analysis showed that women (OR=2.062; 95% CI: 1.076, 3.950), those with longer length of hospital stay (LOS) (OR=1.609; 1.302, 1.988), diabetes mellitus (OR=5.799; 1.540, 21.836) and hypertension (OR=4.371; 2.170, 8.807) had polypharmacy. Meanwhile, women (OR=1.925; 1.078, 3.437) and LOS (OR=1.235; 1.089, 1.401) contributed to patients receiving at least one PIM, whereas, polypharmacy (OR=3.654; 1.685, 7.922), LOS (OR=1.253; 1.156, 1.359), and intensive care admission (OR=1.708; 1.031, 2.828) were associated with having two or more PIMs.
Conclusion: Four out five elderly stroke patients had polypharmacy and PIM, and LOS predicted both. Reducing LOS could be a key focus of interventions to reduce the risk of ADE among hospitalised elderly stroke patients in Indonesia.