PATTERN, PRACTICE AND FACTORS INFLUENCING MULTIPLE MEDICATION USE AMONG ELDERLY ATTENDING GERIATRIC AND MEDICAL OUT-PATIENT CLINICS AT UNIVERSITY COLLEGE HOSPITAL, IBADAN

Abstract

The risk associated with taking multiple medications among the elderly could be well managed if the elderly ones adhere strictly to instructions and the relevant agencies play their respective roles. Previous work has not been able to link the knowledge and perception of the elderly towards the use of multiple medications with the associated risk factors. Consequently, this study considered the pattern, practice and factors influencing multiple medication use among elderly. This study was therefore designed to assess the factors influencing multiple medication use among the elderly attending geriatrics clinic and medical out-patients at University College Hospital Ibadan. A cross sectional study was conducted among 400 purposively selected elderly patients. A pre-tested semi-structured interviewer-administered questionnaire which contained an 8 – point knowledge scale was used to assess the knowledge of the respondents; scores between 0 – 4 indicated poor knowledge while scores greater than 4 indicated good knowledge of multiple medication use. A 12 – points perception scale was used to assess the perception of the respondents; scores between 0 – 5 indicated poor perception and scores greater than 5 indicated good perception of multiple medication use. The data were analyzed using descriptive statistics, logistic regression and Chi-square test at p=0.05. Mean age of respondents was 69.79±8.1, 53.7% were males and 67.5% were married. Majority (66.4%) of the respondents had good knowledge of multiple medications use while the 33.6% had poor knowledge. There was a significant relationship between the monthly income of respondents (X2=22.7976, df=4, p=0.00013), level of education of respondents (X2=11.6064, df=4, p<0.000) and the knowledge on multiple medication use. There was a significant relationship between the knowledge and factors influencing multiple medication use (X2=4.3422, p=0.027). About sixty per cent had poor perception while 40.7% had good perception. There was a significant relationship between factors such as stress of ingesting drugs (X2=15.463,df=1), lack of money for purchasing of prescribed drugs (X2=18.106.df=1), frequent change of medication (X2=20.918 df=1), forgetting to use drugs as prescribed by the doctor (X2=14.989,df=1) and practice of elderly towards multiple medication use. About half (50.2%) of the respondents take more than four medications. Major medications taken by the respondents include Antihypertensive drugs, non-Steroidal Anti-inflammatory Drugs (NSAIDS), oral hypoglycemic agents, insulin and multivitamins. Less than one-fifth of the respondents experience side effects due to these medications. Some of the major side effects experienced include tiredness, insomnia, agitation, and decrease in appetite. Some of the perceived factors influencing multiple medication use include the long queues experienced at clinic, cost of consultation and drugs, ignorance, failure to read drug leaflets, nature of job and lack of information. There was no association between multiple medication use among male and female. Use of multiple medications among patients in UCH is a common phenomenon which can be attributed to prescribing practices of the health workers. Therefore, retraining of prescribers in UCH on the need to reduce multiple medication use in light of possible drug interactions is recommended. Patients should also be educated on the need to prevent self-medications.