1.Inappropriate medication use among elderly patients attending some family health centers in Ulaanbaatar
Enkhchimeg S ; Batbold B ; Gundegmaa Ts
Diagnosis 2025;112(1):85-89
Introduction:
While 10 percent of global total population was above the age of 65 in 2022, it tends to rise to 16 percent in 2050. In the case of our country, as of 2021, individuals aged 60 and above comprised 7.7% of the total population, with tendency of an increase to 11.9% by 2030 and 21.1% by 2050. In 2018, a study conducted in Brazil, involving 573 elderly participants, found that 10.3% regularly taking five or
more medications. This highlights the necessity of studying polypharmacy among the elderly.
Goal:
To identify inappropriate medication use among the elderly
Materials and Methods:
The study was conducted by analytic cross sectional design. Furthermore, the study was conducted during July 1, 2024, to October 1, 2024, in Ulaanbaatar, covering 6 districts. A total of 12 Family Health Centers (FHCs) were selected, including one from an apartment district and one from a ger district
in each area. A random sampling method was used to select 238 elderly individuals aged 55 and above for females and 60 and above for males. From each district, 20 participants were selected, maintaining
a gender ratio of 1:1. Statistical analysis was performed using Pearson’s Chisquare test and multiple logistic regression analysis. The study was conducted after obtaining approval from the research ethics
committee of “Ach” Medical University.
Results:
Among the 238 participants in the study, the gender distribution was equal, with 119 females (50%) and 119 males (50%). When analyzing the primary conditions requiring for regular medication by organ system, cardiovascular diseases were the most common, accounting for 89.9% (214) of total cases.
Among the elderly patients included in the study, 68% were found to have inappropriate medication use. Elderly females, aged 85 years and older (n=6, 100%) demonstrated a statistically significant higher prevalence of inappropriate medication use compared to other age groups (p =.023). Among those with inappropriate medication use, 54.9% were females and 45.1% were males, a difference that was also statistically significant (p = .026). Inappropriate medication use was significantly associated
with the type of medication used for the primary disease (p = .001), dosage (p = .000), duration of use (p = .000), frequency of daily intake (p =.003), use of medications due to comorbidities (p =.000), and
whether the medication was prescribed by a physician (p = .001).According to multivariate logistic regression analysis, age (OR 2.31, 95% CI 1.25–4.29, p = .008), gender (OR 0.574, 95% CI 0.356–0.924, p = .022), education level (OR 2.03, 95% CI 1.21–3.58, p = .008), and pension status (OR 1.03, 95% CI 0.586–1.83, p = .904) were found to be influencing factors for inappropriate medication use.
Conclutions
1. Inappropriate medication use among the elderly accounts for 68%.
2.The study is aimed to investigate polypharmacy of elderly patients who are visiting to Family Health Centers in some districts of Ulaanbaatar
Enkhchimeg S ; Batbold B ; Gundegmaa Ts
Mongolian Medical Sciences 2025;211(1):13-17
Introduction:
While 10 percent of global total population was above the age of 65 in 2022, it tends to rise
to 16 percent in 2050. In the case of our country, as of 2021, individuals aged 60 and above
comprised 7.7% of the total population, with tendency of an increase to 11.9% by 2030 and
21.1% by 2050. In 2018, a study conducted in Brazil, involving 573 elderly participants,
found that 10.3% regularly taking five or more medications. This highlights the necessity of
studying polypharmacy among the elderly.
Materials and Methods :
The study was conducted by analytic crosssectional design. Furthermore, the study was
conducted during July 1, 2024, to October 1, 2024, in Ulaanbaatar, covering 6 districts. A total
of 12 Family Health Centers (FHCs) were selected, including one from an apartment district
and one from a ger district in each area. A random sampling method was used to select 238
elderly individuals aged 55 and above for females and 60 and above for males. From each
district, 20 participants were selected, maintaining a gender ratio of 1:1. Statistical analysis
was performed using Pearson’s Chi-square test and multiple logistic regression analysis.
The study was conducted after obtaining approval from the research ethics committee of
“Ach” Medical University.
Results:
Among the 238 participants in the study, the gender distribution was equal, with 119 females
(50%) and 119 males (50%). When analyzing the primary conditions requiring for regular
medication by organ system, cardiovascular diseases were the most common, accounting
for 89.9% (214) of total cases. A total of 37 elderly patients (15.5%) were found to be on
polypharmacy (taking five or more medications). Males (n=10, 21.3%) had a higher prevalence
of polypharmacy compared to females (n=4, 18.2%).
Polypharmacy was significantly more prevalent among individuals aged 76–84 years, with
a rate of 22.4% (p=0.006). Statistically significant differences were observed between
polypharmacy and factors such as the type of medications taken for primary diseases
(p=0.001), medication dosage (p=0.001), and duration of medication use (p=0.005).
Additionally, polypharmacy showed a significant association with comorbid disease-related
medication use (p=0.002). Elderly individuals with gastrointestinal and musculoskeletal
comorbidities exhibited a higher prevalence of polypharmacy.
Other significant factors associated with polypharmacy included the type of medications
used for comorbid conditions (p=0.001), daily medication frequency (p=0.020), and
adherence to prescribed medications for comorbid conditions (p=0.017). Multivariate
regression analysis identified gender (OR 2.98, 95% CI 1.26-6.97, p=0.007), housing type
(OR 0.283, 95% CI 0.117-0.685, p=0.002), medication dosage (OR 4.62, 95% CI 1.97
10.81, p=0.001), and duration of medication use (OR 0.249, 95% CI 0.098-0.631, p=0.003)
as statistically significant predicting factors of polypharmacy.
Conclusion
The use of polypharmacy in the elderly of Ulaanbaatar is 15.5%.
Result Analysis
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