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Published in: BMC Geriatrics 1/2024

Open Access 01-12-2024 | General Medicine | Research

Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya

Authors: Maureen Kamau, Njeri Nyanja, Adelaide M. Lusambili, Jacob Shabani, Gulnaz Mohamoud

Published in: BMC Geriatrics | Issue 1/2024

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Abstract

Background

Life expectancy has increased over the last century among older people, particularly those aged over 60 years. Aging is associated with increased disability, multiple chronic conditions, and increased use of health services managed with polypharmacy. There are few studies on polypharmacy and aging in sub-Saharan Africa, and it is unclear what older people know and their attitudes toward polypharmacy. This paper presents findings from a study that aimed to understand older people’s knowledge, attitudes and beliefs about polypharmacy.

Methods

A qualitative study using in-depth interviews of 15 patients aged 60 years and older who were taking more than five medications per day. The study was conducted at the Family Medicine Clinic (FMC), Aga Khan University Hospital, Nairobi. Data were analyzed using NVivo 12 software.

Result

Majority of participants had a good understanding of their underlying health conditions, but they did not know the specific names of the medications they were taking. Participants had diverse attitudes toward polypharmacy, with both positive and negative perceptions. Although adverse side effects were reported, participants remained positive because they believed these medicines were beneficial. Religion, faith and living healthy lifestyles were perceived to contribute to their positive attitude toward polypharmacy. Stigma and the cost of medication were reported as barriers.

Conclusion

This study provides valuable insights into the complexities of polypharmacy in older people. It highlights the importance of patient education, fostering strong patient-provider relationships, de-stigmatization, and improving medication affordability and accessibility. Further research could explore the polypharmacy of older people attending public institutions in rural Kenya.
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Literature
3.
go back to reference Margaret M, Mwaila, Mona T, Yousif. Kenya’s ageing population: current and future prospects. World J Adv Res Rev. 2022;16(2):598–610.CrossRef Margaret M, Mwaila, Mona T, Yousif. Kenya’s ageing population: current and future prospects. World J Adv Res Rev. 2022;16(2):598–610.CrossRef
5.
go back to reference He Z, Bian J, Carretta HJ, Lee J, Hogan WR, Shenkman E, et al. Prevalence of multiple chronic conditions among older adults in Florida and the United States: comparative analysis of the OneFlorida Data Trust and National Inpatient Sample. J Med Internet Res. 2018;20(4):e137.CrossRefPubMedPubMedCentral He Z, Bian J, Carretta HJ, Lee J, Hogan WR, Shenkman E, et al. Prevalence of multiple chronic conditions among older adults in Florida and the United States: comparative analysis of the OneFlorida Data Trust and National Inpatient Sample. J Med Internet Res. 2018;20(4):e137.CrossRefPubMedPubMedCentral
7.
go back to reference Al-Mansouri A, Hamad AI, Al-Ali FS, Ibrahim MIM, Kheir N, Al-Ziftawi NH, et al. Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharm J SPJ off Publ Saudi Pharm Soc. 2023;31(5):678–86. Al-Mansouri A, Hamad AI, Al-Ali FS, Ibrahim MIM, Kheir N, Al-Ziftawi NH, et al. Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease. Saudi Pharm J SPJ off Publ Saudi Pharm Soc. 2023;31(5):678–86.
8.
go back to reference Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS ONE. 2021;16(8):e0255642.CrossRefPubMedPubMedCentral Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS ONE. 2021;16(8):e0255642.CrossRefPubMedPubMedCentral
9.
go back to reference Naidoo K, van Wyk J. What the elderly experience and expect from primary care services in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med. 2019;11(1):2100.CrossRefPubMedPubMedCentral Naidoo K, van Wyk J. What the elderly experience and expect from primary care services in KwaZulu-Natal, South Africa. Afr J Prim Health Care Fam Med. 2019;11(1):2100.CrossRefPubMedPubMedCentral
10.
go back to reference Tegegn HG, Erku DA, Sebsibe G, Gizaw B, Seifu D, Tigabe M, et al. Medication-related quality of life among Ethiopian elderly patients with polypharmacy: a cross-sectional study in an Ethiopia university hospital. PLoS ONE. 2019;14(3):e0214191.CrossRefPubMedPubMedCentral Tegegn HG, Erku DA, Sebsibe G, Gizaw B, Seifu D, Tigabe M, et al. Medication-related quality of life among Ethiopian elderly patients with polypharmacy: a cross-sectional study in an Ethiopia university hospital. PLoS ONE. 2019;14(3):e0214191.CrossRefPubMedPubMedCentral
11.
go back to reference Langmann E. Vulnerability, ageism, and health: is it helpful to label older adults as a vulnerable group in health care? Med Health Care Philos. 2023;26(1):133–42.CrossRefPubMed Langmann E. Vulnerability, ageism, and health: is it helpful to label older adults as a vulnerable group in health care? Med Health Care Philos. 2023;26(1):133–42.CrossRefPubMed
13.
go back to reference Mangin D, Bahat G, Golomb BA, Mallery LH, Moorhouse P, Onder G, et al. International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): position Statement and 10 recommendations for action. Drugs Aging. 2018;35(7):575–87.CrossRefPubMedPubMedCentral Mangin D, Bahat G, Golomb BA, Mallery LH, Moorhouse P, Onder G, et al. International Group for Reducing Inappropriate Medication Use & Polypharmacy (IGRIMUP): position Statement and 10 recommendations for action. Drugs Aging. 2018;35(7):575–87.CrossRefPubMedPubMedCentral
15.
go back to reference Schöpf AC, von Hirschhausen M, Farin E, Maun A. Elderly patients’ and GPs’ perspectives of patient-GP communication concerning polypharmacy: a qualitative interview study. Prim Health Care Res Dev. 2018;19(4):355–64.CrossRefPubMed Schöpf AC, von Hirschhausen M, Farin E, Maun A. Elderly patients’ and GPs’ perspectives of patient-GP communication concerning polypharmacy: a qualitative interview study. Prim Health Care Res Dev. 2018;19(4):355–64.CrossRefPubMed
16.
go back to reference Stefanacci RG, Khan T. Can Managed Care Manage Polypharmacy? Clin Geriatr Med. 2017;33(2):241–55.CrossRefPubMed Stefanacci RG, Khan T. Can Managed Care Manage Polypharmacy? Clin Geriatr Med. 2017;33(2):241–55.CrossRefPubMed
17.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
18.
go back to reference Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18(1):59–82.CrossRef Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18(1):59–82.CrossRef
19.
go back to reference Morse JM. Qual Health Res. 2015;25(5):587–8. Data were saturated. Morse JM. Qual Health Res. 2015;25(5):587–8. Data were saturated.
20.
go back to reference Beuscart JB, Petit S, Gautier S, Wierre P, Balcaen T, Lefebvre JM, et al. Polypharmacy in older patients: identifying the need for support by a community pharmacist. BMC Geriatr. 2019;19(1):277.CrossRefPubMedPubMedCentral Beuscart JB, Petit S, Gautier S, Wierre P, Balcaen T, Lefebvre JM, et al. Polypharmacy in older patients: identifying the need for support by a community pharmacist. BMC Geriatr. 2019;19(1):277.CrossRefPubMedPubMedCentral
21.
go back to reference Berkelmans PG, Berendsen AJ, Verhaak PF, van der Meer K. Characteristics of general practice care: what do senior citizens value? A qualitative study. BMC Geriatr. 2010;10(1):80.CrossRefPubMedPubMedCentral Berkelmans PG, Berendsen AJ, Verhaak PF, van der Meer K. Characteristics of general practice care: what do senior citizens value? A qualitative study. BMC Geriatr. 2010;10(1):80.CrossRefPubMedPubMedCentral
22.
go back to reference Atinga RA, Yarney L, Gavu NM. Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: a qualitative investigation. PLoS ONE. 2018;13(3):e0193995.CrossRefPubMedPubMedCentral Atinga RA, Yarney L, Gavu NM. Factors influencing long-term medication non-adherence among diabetes and hypertensive patients in Ghana: a qualitative investigation. PLoS ONE. 2018;13(3):e0193995.CrossRefPubMedPubMedCentral
23.
24.
go back to reference Moen J, Antonov K, Larsson CA, Lindblad U, Nilsson JLG, Råstam L, et al. Factors Associated with multiple medication use in different age groups. Ann Pharmacother. 2009;43(12):1978–85.CrossRefPubMed Moen J, Antonov K, Larsson CA, Lindblad U, Nilsson JLG, Råstam L, et al. Factors Associated with multiple medication use in different age groups. Ann Pharmacother. 2009;43(12):1978–85.CrossRefPubMed
25.
go back to reference Eriksen CU, Kyriakidis S, Christensen LD, Jacobsen R, Laursen J, Christensen MB, et al. Medication-related experiences of patients with polypharmacy: a systematic review of qualitative studies. BMJ Open. 2020;10(9):e036158.CrossRefPubMedPubMedCentral Eriksen CU, Kyriakidis S, Christensen LD, Jacobsen R, Laursen J, Christensen MB, et al. Medication-related experiences of patients with polypharmacy: a systematic review of qualitative studies. BMJ Open. 2020;10(9):e036158.CrossRefPubMedPubMedCentral
26.
go back to reference Nwanaji-Enwerem JC, Boyer EW, Olufadeji A, Polypharmacy, Exposure. Aging populations, and COVID-19: considerations for Healthcare Providers and Public Health Practitioners in Africa. Int J Environ Res Public Health. 2021;18(19):10263.CrossRefPubMedPubMedCentral Nwanaji-Enwerem JC, Boyer EW, Olufadeji A, Polypharmacy, Exposure. Aging populations, and COVID-19: considerations for Healthcare Providers and Public Health Practitioners in Africa. Int J Environ Res Public Health. 2021;18(19):10263.CrossRefPubMedPubMedCentral
27.
go back to reference Santibáñez-Beltrán S, Villarreal-Ríos E, Galicia-Rodríguez L, Martínez-González L, Vargas-Daza E, Ramos-López E. Economic cost of polypharmacy in the elderly in primary health care. Rev Médica Inst Mex Seguro Soc. 2013;51(2):192–9. Santibáñez-Beltrán S, Villarreal-Ríos E, Galicia-Rodríguez L, Martínez-González L, Vargas-Daza E, Ramos-López E. Economic cost of polypharmacy in the elderly in primary health care. Rev Médica Inst Mex Seguro Soc. 2013;51(2):192–9.
Metadata
Title
Knowledge, attitudes and beliefs toward polypharmacy among older people attending Family Medicine Clinic, Nairobi, Kenya
Authors
Maureen Kamau
Njeri Nyanja
Adelaide M. Lusambili
Jacob Shabani
Gulnaz Mohamoud
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-024-04697-9

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