Prevalence of Polypharmacy and Potentially Inappropriate Prescribing (PIP) among Older Adults Aged 65 Years and above in Brunei Darussalam
- Author:
Sebastian Eng Chong KOH
;
Maggie SIM
;
Lina Maziyyah PG METUSSIN
;
Pey Siaw LIM
;
Su Ying YEO
;
Yung Shin YEO
;
Wai See WONG
;
Shyh Poh TEO
;
Li Ling CHAW
- Publication Type:Original Article
- Keywords:
Aged;
Electronic health records;
Medication review;
Polypharmacy;
Inappropriate prescribing 31 Sebastian Eng Chong KOH1*;
Maggie SIM1;
Lina Maziyyah PG METUSSIN1;
Pey Siaw LIM1;
Su Ying YEO1;
Yung Shin YEO1;
Wai See WONG1;
Shyh Poh TEO2,3;
Li Ling CHAW3
- From:
Brunei International Medical Journal
2026;22():97-104
- CountryBrunei Darussalam
- Language:English
-
Abstract:
Introduction: Polypharmacy and potentially inappropriate prescribing (PIP) are increasingly recognised as important contributors to medication -related harm among older adults. However, published national data on the prevalence of polypharmacy and PIP in Brunei Darussalam are unavailable. The objectives of this study was to determine the prevalence of polypharmacy and PIP among adults aged 65 years and above in Brunei Darussalam using Screening Tool of Older Persons ’ potentially inappropriate Prescriptions (STOPP) version 2 criteria. Materials and Methods: A retrospective cross -sectional study was conducted using data from the Brunei Healthcare Information Management System (Bru -HIMS). A stratified proportional random sample of 2,000 older adults with documented medical encounters in 2016 was selected. Polypharmacy was defined as the concurrent use of five or more medications. PIP was assessed using STOPP version 2 criteria. Descriptive statistics were used to summarise prescribing patterns. Results: Of the 2000 older adults included (mean age 73.0 ± 6.6 years), 1,181 (59.1%) had polypharmacy. Among those with polypharmacy, 1,057 (89.5%) could be assessed using STOPP criteria, and 206 (19.5%) had at least one PIP. The most frequently identified PIPs involved prolonged use of proton pump inhibitors for uncomplicated peptic ulcer disease at full therapeutic dosage for more than eight weeks, where dose reduction, discontinuation, or transition to maintenance therapy (e.g. H2 receptor antagonists) is indicated, prescribing without evidence -based indication, duplication of drug classes, use of ACE inhibitors or angiotensin receptor blockers in patients with hyperkalaemia, and use of first -generation antihistamines. Conclusion: Polypharmacy and PIP are common among older adults in Brunei Darussalam. The findings highlight the need for systematic medication review and deprescribing strategies to optimise pharmacotherapy and improve medication safety in older populations
