# Assessing potentially inappropriate medication use among older adults in Central and Eastern Europe

## TL;DR

This study finds that many older adults in Central and Eastern Europe are using medications that may be inappropriate, with big differences between countries.

## Contribution

The study provides the first comprehensive assessment of PIM use in five Central and Eastern European countries using a large sample and EU(7)-PIM criteria.

## Key findings

- 56% of older adults used potentially inappropriate medications.
- Benzodiazepines, NSAIDs, and long-term PPIs were the most common PIMs.
- Risk factors included residence, comorbidity burden, and polypharmacy.

## Abstract

The aim of this study was to examine the prevalence of potentially inappropriate medication (PIM) use and its associated risk factors in community-dwelling older adults from five Central and Eastern European (CEE) countries.

This secondary analysis of a cross-sectional survey, which was part of the Horizon 2020 EuroAgeism ESR7 project, was conducted between February 2019 and March 2020 in Bulgaria, Croatia, Czechia, Estonia, and Serbia. We enrolled older adults aged ≥65 years who visited community pharmacies to acquire medications. The prevalence of PIM use was determined by applying all 282 criteria from the EU(7)-PIM list. Risk and protective factors for PIM use were evaluated using multiple logistic regression. R software version 4.3.2 was used in statistical analysis.

Most of the 2,155 participants were women (63.3%) and aged 65–74 years (64.8%). The overall PIM prevalence was 56.0% (95% confidence interval 53.8%–58.1%), ranging from 29.5% in Czechia to 70.0% in Croatia. The most commonly used PIMs were benzodiazepines (16.7% of all PIMs), followed by nonsteroidal anti-inflammatory drugs (14.3%), and proton pump inhibitors taken for more than 8 weeks (14.1%). Multiple logistic regression revealed that residence, increasing comorbidity burden, and polypharmacy were significant risk factors associated with PIM use in older adults.

Our findings demonstrate a high prevalence of PIM use among older patients from CEE countries and considerable cross-country differences, underscoring the need to improve medication prescribing for older adults to improve healthcare quality and patient outcomes.

Potentially inappropriate medication use is widespread in Central and Eastern Europe.It is necessary to improve the prescribing process for older adults worldwide.

Potentially inappropriate medication use is widespread in Central and Eastern Europe.

It is necessary to improve the prescribing process for older adults worldwide.