Low-Value Prescribing Among Older Adults With Psychiatric Disorders in a Lebanese Geriatric Care Hospital: A...

Low-value prescribing (LVP) refers to the use of medications whose potential risks or costs outweigh their expected clinical benefits and is increasingly recognized as an important concern in the pharmacological management of older adults. This study aimed to assess the prevalence of low-value prescribing (LVP) and associated factors among hospitalized older adults with psychiatric disorders in Lebanon using the Evaluating Opportunities to Decrease Low-Value Prescribing-Rx (EVOLV-RX) tool.

A cross-sectional study was conducted from May 2022 to December 2022 among hospitalized patients aged ≥ 60 years with diagnosed psychiatric disorders receiving care in the geriatric division of a care hospital in Beirut during the study period. Patients with complete medical records and receiving at least one chronic medication were eligible for inclusion. Low-value prescribing was assessed using the EVOLV-Rx tool. Descriptive statistics were used to describe independent variables. Bivariate and logistic regression analyses were performed to identify factors associated with LVP.

The study included 180 patients, 128 (71.1%) of whom had at least one low-value prescription. The most frequently identified LVP was the use of proton pump inhibitors for more than two consecutive months, observed in 57 patients (31.7%), followed by the concomitant use of highly anticholinergic drugs (47, 26.1%), therapeutic duplication of antipsychotics and sleep medications (25, 13.9%), and therapeutic duplication of antipsychotics (22, 12.2%). In adjusted analyses, both polypharmacy and smoking were significantly associated with the presence of low-value prescribing.

LVP was highly prevalent among hospitalized older adults in a psychogeriatric care setting in Lebanon. The observed associations with polypharmacy and smoking highlight the importance of structured medication review and deprescribing strategies in this population.