A study of medication safety in rural older people in Luzhou City

To assess the current status and determinants of medication safety among rural older residents in Luzhou City, with the aim of informing targeted strategies to promote safe and rational medication use.

A cross-sectional study was conducted involving 100 older adults (≥60 years) and 60 primary care physicians from rural Luzhou. Data collection included structured questionnaires on medication use, adherence, and safety knowledge, as well as a review of 100 outpatient electronic medical records (EMRs) for chronic disease management. Prescription rationality was evaluated using the Medication Appropriateness Index (MAI), and potentially inappropriate medications (PIMs) were identified according to the 2023 American Geriatrics Society Beers Criteria. Descriptive statistics and chi-square tests were applied to examine associations between sociodemographic factors and unsafe medication practices.

Polypharmacy (≥3 concurrent medications) was reported by 72% of older participants, with 81% taking antihypertensive or cardiovascular drugs. Unsafe practices were common: 47% altered medication timing or missed doses, and 37% self-adjusted dosages. Knowledge gaps were evident, as only 43% consulted pharmacists about dosing or precautions, and just 23% would discontinue a drug and seek help if experiencing an adverse reaction. Lower education and household income were significantly associated with unsafe behaviors (p = 0.014). Among EMRs reviewed, 2% of prescriptions were rational, and 12% contained PIMs, most frequently long-acting benzodiazepines and NSAIDs.

Rural older people in Luzhou face significant medication safety challenges, driven by high rates of polypharmacy, unsafe self-management behaviors, and socioeconomic disparities. Interventions should combine patient education, improved physician-patient communication, and systematic prescription review to reduce inappropriate medication use and related adverse outcomes.