AUTHOR=Jabri Fouad F. , Liang Yajun , Johnell Kristina , Möller Jette 

TITLE=Trajectories of potentially inappropriate medication use among older adults in Saudi Arabia

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1568160

DOI=10.3389/fphar.2025.1568160

ISSN=1663-9812

ABSTRACT=BackgroundThe trajectories of potentially inappropriate medications (PIMs) among older adults have not been well studied. This study aims to determine the 3-year trajectories of PIM dispensation and their determinants in older adults in Saudi Arabia.MethodsA cohort study was carried out based on medical records from visits by 9,887 older adults (≥65 years) to outpatient clinics at King Saud University Medical City in Saudi Arabia from 2017 to 2019. PIMs were identified using the 2019 Beers Criteria, using the first category: medications that should be avoided by most older adults. Multinomial logistic regression was used to estimate the associations between clinical factors and the trajectories of PIM adjusting for sociodemographic factors.ResultsThe analysis showed that over 82% dispensed at least one PIM, with 55.9% having sustained PIMs, 17.9% having no PIMs, 14.0% starting PIMs, and 12.2% experiencing sporadic PIM dispensations. After adjustment, metabolic disorders (adjusted odds ratio [aOR]: 2.61, 95% confidence interval [95% CI]: 2.17–3.15), hypertensive diseases (aOR: 5.32, 95% CI: 4.67–6.07), diabetes mellitus (aOR: 10.22, 95% CI: 8.80–11.86), and diseases of the esophagus, stomach, or duodenum (aOR: 10.90, 95% CI: 7.39–16.09) were significantly associated with sustained PIM dispensation. With an increasing number of diagnoses we found an increasing odds for three trajectories (starting PIM (aOR range 1.56 to 5.82), sporadic PIM (aOR range 1.47 to 4.86), and sustained PIM (aOR range 3.91 to 37.3). Furthermore, an increasing number of medications was associated with higher odds for the same trajectories: starting PIM (aOR range 2.01 to 6.03), sporadic PIM (aOR range 1.50 to 7.10), and sustained PIM (aOR range 4.34 to 59.9).ConclusionThis study showed a high prevalence of sustained trajectories of PIMs over time. Further, several common diagnoses and a greater total number of medications were identified as being associated with different PIM trajectories.