Faculty
Department
Year of Publication
upload
Publication Type
Abstract
Background Polypharmacy—commonly understood as someone taking five or more
medicines at the same time—has become a major concern in geriatric populations with
chronic diseases, contributing to increased risks of adverse drug reactions, harmful drug
interactions, poor medication adherence, and an overall decline in a person’s quality of life. In Nigeria, where healthcare systems face challenges like reduced access to specialized
geriatric care and increased rates of inappropriate prescribing, the prevalence of
polypharmacy remains understudied. Deprescribing—the supervised withdrawal or dose reduction of unnecessary or potentially harmful medications—offers a promising strategy to
optimize pharmacotherapy, but its implementation is influenced by patient attitudes, healthcare provider practices, and systemic barriers. This study evaluates the extent of
polypharmacy and explores deprescribing opportunities among geriatric patients with chronic
diseases at the University of Benin Teaching Hospital (UBTH), a tertiary care facility in
southern Nigeria. Objective: The primary aim was to determine the prevalence and associated factors of polypharmacy in geriatric patients with chronic conditions. Secondary objectives included assessing patients' attitudes toward deprescribing, identifying potentially inappropriate
medications (PIMs) using established criteria (STOPP/START). Method: A cross-sectional, observational study was conducted. Participants were geriatric greater than 60 years. Data were collected using structured questionnaires containing demographics information, medication use, patients’ attitude towards deprescription and an investigator filled portion containing details on comorbidities, specific medication (including
OTC), Patients diagnosis, PIMs. The PIMs were identified using the START/STOPP criterial. Statistics analysis used were descriptive (frequencies, means, percentage) with inferential
statistics (chi square) to explore association between polypharmacy and factor like age, comorbidities etc RESULTS: The results from the study shows of the 240 geriatric patients (mean age 70.38 ±
4.13 years; 56.3% male) at UBTH, Nigeria: Sociodemographic: Predominantly 60–79 years
(96.6%), with primary/secondary education (75.4%). Comorbidity Count: 86.7% had ≥1
comorbidity (most common: 2–4); significant age variation (χ²=27.487, p=0.025). Polypharmacy: 74.2% (178 /240) on ≥ 5 medications; moderate positive correlation with comorbidities (r=0.517, p<0.01; χ²=215.89, p<0.001) . No gender difference. PIMs: 20% (48/240) had ≥1 PIM (72.9% inappropriate use, 27.1% d rugs to avoid); increased with drug
count ( highest at 8 drugs: 69.2%; χ²=46.091, p<0.001). Deprescribing Attitudes: Highly
positive (mean score 3.70 ± 0.31); 98% trusted doctor, 93.3% willing to stop meds if advised, 65.5% felt over-medicated, 68.4% concerned about side effects. CONCLUSION: Polypharmacy is alarmingly prevalent (74.2%) among elderly Nigerian patients with chronic multimorbidity, strongly linked to comorbidity burden and associated with a high rate of PIMs (20%). Patients exhibit strongly positive attitudes toward deprescribing, driven by trust in physicians. Routine PIM screening (STOPP criteria) and
physician-led deprescribing interventions are urgently needed to reduce pill burden, minimize
risks, and increase quality of life in this vulnerable population
medicines at the same time—has become a major concern in geriatric populations with
chronic diseases, contributing to increased risks of adverse drug reactions, harmful drug
interactions, poor medication adherence, and an overall decline in a person’s quality of life. In Nigeria, where healthcare systems face challenges like reduced access to specialized
geriatric care and increased rates of inappropriate prescribing, the prevalence of
polypharmacy remains understudied. Deprescribing—the supervised withdrawal or dose reduction of unnecessary or potentially harmful medications—offers a promising strategy to
optimize pharmacotherapy, but its implementation is influenced by patient attitudes, healthcare provider practices, and systemic barriers. This study evaluates the extent of
polypharmacy and explores deprescribing opportunities among geriatric patients with chronic
diseases at the University of Benin Teaching Hospital (UBTH), a tertiary care facility in
southern Nigeria. Objective: The primary aim was to determine the prevalence and associated factors of polypharmacy in geriatric patients with chronic conditions. Secondary objectives included assessing patients' attitudes toward deprescribing, identifying potentially inappropriate
medications (PIMs) using established criteria (STOPP/START). Method: A cross-sectional, observational study was conducted. Participants were geriatric greater than 60 years. Data were collected using structured questionnaires containing demographics information, medication use, patients’ attitude towards deprescription and an investigator filled portion containing details on comorbidities, specific medication (including
OTC), Patients diagnosis, PIMs. The PIMs were identified using the START/STOPP criterial. Statistics analysis used were descriptive (frequencies, means, percentage) with inferential
statistics (chi square) to explore association between polypharmacy and factor like age, comorbidities etc RESULTS: The results from the study shows of the 240 geriatric patients (mean age 70.38 ±
4.13 years; 56.3% male) at UBTH, Nigeria: Sociodemographic: Predominantly 60–79 years
(96.6%), with primary/secondary education (75.4%). Comorbidity Count: 86.7% had ≥1
comorbidity (most common: 2–4); significant age variation (χ²=27.487, p=0.025). Polypharmacy: 74.2% (178 /240) on ≥ 5 medications; moderate positive correlation with comorbidities (r=0.517, p<0.01; χ²=215.89, p<0.001) . No gender difference. PIMs: 20% (48/240) had ≥1 PIM (72.9% inappropriate use, 27.1% d rugs to avoid); increased with drug
count ( highest at 8 drugs: 69.2%; χ²=46.091, p<0.001). Deprescribing Attitudes: Highly
positive (mean score 3.70 ± 0.31); 98% trusted doctor, 93.3% willing to stop meds if advised, 65.5% felt over-medicated, 68.4% concerned about side effects. CONCLUSION: Polypharmacy is alarmingly prevalent (74.2%) among elderly Nigerian patients with chronic multimorbidity, strongly linked to comorbidity burden and associated with a high rate of PIMs (20%). Patients exhibit strongly positive attitudes toward deprescribing, driven by trust in physicians. Routine PIM screening (STOPP criteria) and
physician-led deprescribing interventions are urgently needed to reduce pill burden, minimize
risks, and increase quality of life in this vulnerable population
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