Assessment of Drug-Related Problems, Medication Adherence and Polypharmacy Among Elderly Outpatients in Sana'a City, Yemen
DOI:
https://doi.org/10.65693/irss.2026.v7i2.344Keywords:
, polypharmacy, medication adherence, drug related problemAbstract
Geriatric polypharmacy significantly increases the risk of drug-related problems (DRPs), potentially inappropriate medications, and poor adherence, especially in resource-limited settings such as Yemen. Despite the worldwide use of validated tools such as the AGS Beers Criteria and GMAS, local data are still limited. This study evaluates the prevalence of PIMs and medication adherence among elderly outpatients in Sana'a to provide data for optimizing geriatric pharmacotherapy and enhancing patient safety.
Aim: To evaluate medication adherence among elderly outpatients use the General Medication Adherence Scale (GMAS) and to assessment the prevalence of drug-related problems (DRPs) among elderly patients use the AGS Beers Criteria in the context of polypharmacy.
Methods: This cross-sectional study (Dec 2025–Feb 2026) involved 214 elderly outpatients (≥55 years) in Sana'a. Data were collected by interviews using a structured form. DRPs and PIMs were identified using AGS 2023 Beers Criteria and Lexicomp, while adherence was measured by the GMAS scale. Statistical analysis was performed using SPSS, applying Chi-square tests (P < 0.05) to assess associations between polypharmacy, DRPs, and adherence. Ethical approval was secured from 21 UMAS and participating hospitals.
Results: Excessive Polypharmacy (≥10 drugs) was prevalent in 13.6% of patients, with a mean of 7.30 ± 2.00 medications. DRPs were highly prevalent, occurring in 94.4% of the cohort. Specifically, 83.2% of patients were prescribed at least one PIM, with PPI (67.8%) and aspirin (21.0%) are the most common. Furthermore, 53.7% received drugs requiring caution, and 74.8% experienced at least one DDI. Suboptimal medication adherence was observed in 52.8% of patients. Excessive polypharmacy was significantly associated with major DDIs (P < 0.001) and higher rates of non-adherence (P < 0.001). Financial constraints and complex medication regimens were identified as primary barriers to adherence.
Conclusion: This study reveals a high burden of polypharmacy and PIMs among elderly Yemeni outpatients, coupled with suboptimal adherence rates. These findings underscore the urgent need for clinical pharmacist-led medication reviews and the implementation of de-prescribing protocols to optimize geriatric pharmacotherapy and improve clinical outcomes in Yemen.
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