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ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1568160
Trajectories of Potentially Inappropriate Medication Use among Older Adults in Saudi Arabia
Provisionally accepted- 1College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- 2Department of Global Public Health, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
- 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet (KI), Stockholm, Stockholm, Sweden
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The trajectories of potentially inappropriate medications (PIMs) among older adults have not been well studied. This study aims to determine the three-year trajectories of PIM dispensation and their determinants in older adults in Saudi Arabia. Methods: A cohort study was carried out based on medical records from visits by 9,887 older adults (≥65 years) to outpatient clinics at King Saud University Medical City in Saudi Arabia from 2017 to 2019. PIMs were identified using the 2019 Beers Criteria, using the first category: medications that should be avoided by most older adults. Multinomial logistic regression was used to estimate the associations between clinical factors and the trajectories of PIM adjusting for sociodemographic factors. Results: The analysis showed that over 82% dispensed at least one PIM, with 55.9% having sustained PIMs, 17.9% having no PIMs, 14.0% starting PIMs, and 12.2% experiencing sporadic PIM dispensations. After adjustment, metabolic disorders (adjusted odds ratio [aOR]: 2.61, 95% confidence interval [95% CI]: 2.17-3.15), hypertensive diseases (aOR: 5.32, 95% CI: 4.67-6.07), diabetes mellitus (aOR: 10.22, 95% CI: 8.80-11.86), and diseases of the esophagus, stomach, or duodenum (aOR: 10.90, 95% CI: 7.39-16.09) were significantly associated with sustained PIM dispensation. With an increasing number of diagnoses we found an increasing odds for three trajectories (starting PIM (aOR range 1.56 to 5.82), sporadic PIM (aOR range 1.47 to 4.86), and sustained PIM (aOR range 3.91 to 37.3). Furthermore, an increasing number of medications was associated with higher odds for the same trajectories: starting PIM (aOR range 2.01 to 6.03), sporadic PIM (aOR range 1.50 to 7.10), and sustained PIM (aOR range 4.34 to 59.9). Conclusions: This study showed a high prevalence of sustained trajectories of PIMs over time. Further, several common diagnoses and a greater total number of medications were identified as being associated with different PIM trajectories.
Keywords: older adults, Beers criteria, Potentially inappropriate medications, Inappropriate Prescribing, Outpatients
Received: 28 Jan 2025; Accepted: 16 Apr 2025.
Copyright: © 2025 Jabri, Liang, Johnell and Möller. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fouad F. Jabri, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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