Patterns of medication use and risks among elderly patients in primary and tertiary care hospitals in Thailand: A cross-sectional study

BackgroundElderly patients with polypharmacy are at an increased risk of medication-related problems in healthcare settings.ObjectiveThis cross-sectional study aimed to explore medication use patterns and related risks in patients of both primary and tertiary care hospitals.MethodsData were collected from 460 hypertensive patients attending tertiary care clinics and 101 elderly patients from home visits in primary care settings.ResultsPolypharmacy and potentially inappropriate medication (PIM) use were prevalent in both settings. In a tertiary care hospital, polypharmacy and PIM use was found 57.4% and 28.9%, respectively, whereas in primary care hospitals, the rates were 49.5% and 24.8%. Concurrent polypharmacy and PIM use occurred with 24.8% and 19.8% of tertiary care and primary care patients. All patients with mental or neurological disorders (12.4% in tertiary care and 9.9% in primary care) had PIMs from benzodiazepines. Thus, polypharmacy was significantly a risk factor for PIM use in both settings - primary care hospitals (OR = 6.13, 95% CI: 2.08-18.11) and a tertiary care hospital (OR = 7.08, 95% CI: 4.16-12.05).ConclusionPolypharmacy and mental disorders significantly increase medication risks in the elderly. Careful monitoring of prescriptions for mental conditions and proactive home visits can enhance self-medication and treatment adherence.