Medication-based profiling of older orthopedic patients: a multicenter cross-sectional study

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Pharmacology

Background:

• Managing medication in elderly orthopedic patients is crucial for longevity.
• Polypharmacy, potentially inappropriate medications (PIMs), and fall risk-increasing drugs (FRIDs) are concerns in this population.
• The medication profiles of older orthopedic patients require further investigation.

Purpose of the Study:

• To investigate medication-based profiles in older orthopedic patients.
• To identify critical concerns regarding polypharmacy, PIMs, and FRIDs.
• To compare medication use across different orthopedic conditions.

Main Methods:

• Retrospective review of clinical data from patients aged ≥65 undergoing orthopedic surgery.
• Polypharmacy defined as ≥6 prescribed drugs.
• PIMs and FRIDs identified based on established guidelines.

Main Results:

• 995 patients assessed: 57.4% polypharmacy, 66.0% PIMs, 41.7% FRIDs.
• Higher prevalence of polypharmacy and PIMs in degenerative spinal disease vs. extremity disease.
• Increased use of antiemetics and NSAIDs in degenerative spinal disease, particularly lumbar conditions.

Conclusions:

• Polypharmacy and PIM use are prevalent in older orthopedic patients.
• Degenerative spinal disease is associated with higher rates of polypharmacy and PIM use.
• High antiemetic and NSAID use in lumbar spine conditions warrants attention.