Medication appropriateness in elderly patients with chronic respiratory disease: Insights from the medication appropriateness index

Pharmacy Practice

  • Qusai Y. Al-Share1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
  • Afnan A. Abu Shqair1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
  • Rawand A. Khasawneh1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
  • Amal J. Albadawi1Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.
  • Asmaa Ghneimat2Department of Clinical Pharmacy, King Abdullah University Hospital, P.O. Box 20, Irbid 22110, Jordan.

Volume 22 Issue 4 Pages 1-7

DOI: 10.18549/PharmPract.2024.4.3058

Abstract

Background: This study was conducted at a respiratory disease outpatient clinic. The Medication Appropriateness Index (MAI) was used to assess potentially inappropriate medication (PIM) prescribing, the prevalence of PIM prescription, explore associated factors, and evaluate the reliability of the MAI in this disease area. Methods: A cross-sectional study at King Abdullah University Hospital (KAUH), a tertiary teaching hospital in Jordan. It included data from 70 older adults with chronic respiratory diseases and polypharmacy. The MAI was utilized by two clinical pharmacists to gauge the appropriateness of prescribed medications. Multivariate linear regression was used to analyze the factors influencing PIM prescription, while interrater reliability was assessed using the kappa statistic. Results: Among 70 patients (mean age: 74.16±6.45 years), 97.1% had at least one PIM, and 38.7% of the medications were deemed inappropriate. Polypharmacy correlated independently with increased MAI scores (OR:3.739; p<0.001). Good interrater agreement (κ=0.6) was observed. Conclusion: A high PIM prescription prevalence existed among older adults with chronic respiratory diseases (CRDs) and polypharmacy in respiratory outpatient settings. Polypharmacy significantly correlated with PIM prescription. The MAI demonstrated validity and reliability in identifying medication inappropriateness. These findings emphasize the need for tailored interventions to optimize medication management in this vulnerable population.

Keywords

  • respiratory diseases
  • polypharmacy
  • potentially inappropriate prescribing
  • pharmacist
  • Medication Appropriateness Index
Pharmacy Practice

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