Potentially inappropriate medication use and associated factors among older adults in Ethiopia: a systematic review...

Globally, the proportion of aging population is exponentially and rapidly growing. It is estimated that the number of people 65 years or older was 727 million in 2020. This systematic review and meta-analysis aim to assess potentially inappropriate medication use and associated factors among older adults in Ethiopia.

Primary studies were extensively searched from databases such as PubMed, Scopus and HINARI. Observational studies conducted among older adults ≥60 years old and published in English language were included in the review. After screening, Joanna Brigs Institute (JBI) critical appraisal tool was used to assess studies and data were extracted using a checklist. Heterogeneity was assessed using forest plot, Cochran's Q Test and I². The random effects meta-analysis model was employed to pool the prevalence of potentially inappropriate medication use among older adults in Ethiopia. Subgroup analysis and meta-regression were performed to identify the sources of heterogeneity. Publication bias was assessed using funnel plots with Egger's test.

The review was conducted among 15 cross-sectional studies with a total sample size of 4804 older adults ≥60 years old. The pooled estimate of potentially inappropriate medication use among older adults in Ethiopia was 42.11% (95% CI 31.68, 52.54; P < 0.0001) with high heterogeneity (I ² = 98.49%, p < 0.001). The prevalence of PIMs among studies conducted before 2018 was low (24.97% (15.90%, 34.03%)) compared to studies conducted 2018 and above (50.60% (38.14%, 63.05%)). The most common drug used inappropriately among older adults in Ethiopia was Nifedipine 230 (13.6%). Polypharmacy was significantly and positively associated with PIM use among older adults in Ethiopia.

The pooled prevalence of potentially inappropriate medication among older adults in Ethiopia is high indicating two out of five older adults used inappropriate medication. This review is crucial to MOH of Ethiopia, healthcare professionals and researchers.