Inappropriate medication use and associated factors in geriatric patients with hypertension and diabetes

The potentially inappropriate medications (PIMs) are a list of drugs that should be avoided or used with caution in geriatric patients. Therefore, the aim of this study was to explore the prevalence of PIMs use and potential risk factors in geriatric patients with diabetes mellitus (DM) and hypertension (HTN).

This cross-sectional study was conducted between June 1, 2023, and October 31, 2024. Data were obtained from the outpatient clinics of elderly people aged 65 years and older. The 2023 updated Beers Criteria, developed by the American Geriatrics Society, was used to determine the use of PIMs among persons aged ≥65 years. The prevalence of PIMs was based on ≥1 PIM prescription divided by the total number of patients. Data analyzed using SPSS; Chi-square test, independent samples t-test, and logistic regression analysis were performed.

The entire sample included 198 patients with DM and HTN; 58.6% of the study participants showed PIM use. The most frequently prescribed classes of PIMs that should be avoided were gastrointestinal agents (n = 136). The multivariable logistic regression showed a considerably higher risk of PIMs in females (adjusted odds ratio [AOR] = 2.59, 95% confidence interval [CI]: 1.20-5.60), people with genitourinary diseases (AOR = 3.88, 95% CI: 1.53-9.87), and polypharmacy (AOR = 1.09, 95% CI: 1.05-1.13). The most frequently used PIM that should be avoided was proton-pump inhibitors (97.8%). In contrast, the PIM that should be used with caution was dapagliflozin (99.0%).

The prevalence of PIMs was high in geriatric patients with DM and HTN. In addition, the predictors that could significantly affect the PIMs were female gender, comorbid genitourinary disease, and polypharmacy. Thus, the results of this study could help healthcare providers improve safe prescribing for geriatric patients diagnosed with DM and HTN.