Prevalence of Polypharmacy and Potentially Inappropriate Medications in Older Adults in Long-Term Community Care Homes: A Multicenter, Cross-Sectional Observational Study

The global demographic shift toward an aging population has increased the prevalence of chronic diseases and pharmacotherapy, often leading to polypharmacy and a heightened risk of adverse drug events. The aim of this study was to quantify the prevalence of polypharmacy and characterize patterns of drug use, including potentially inappropriate medications, among older adults residing in Malta’s long-term community care homes. A multicenter, cross-sectional observational study was conducted across four state-run care homes in Malta. Data were collected from the medical records of consenting residents, covering demographics, multimorbidities, functional dependency, and drug use. Inappropriate use of medications and drug–drug interactions were identified using the STOPP/START criteria and the EPOCRATES Online Web Checker. Nearly all participants (93.7%) were exposed to polypharmacy, with 19.7% of the 1969 prescriptions analyzed meeting the criteria for inappropriate medication use. The most frequent potentially inappropriate medications included the prolonged use of proton pump inhibitors (47.6%), loop diuretics (40.3%), and antipsychotics (30.4%). Notable therapeutic gaps included the suboptimal anticoagulation rates in residents with atrial fibrillation and the absence of regular bronchodilator use among residents with chronic obstructive pulmonary disease. Potential risk for orthostatic hypotension was the most common drug interaction, affecting 63.4% of participants. While the frequency of potentially inappropriate medications was comparatively low, the widespread prevalence of polypharmacy, antipsychotic administration, and essential treatment gaps necessitates immediate clinical intervention. Standardizing the use of STOPP/START criteria and implementing regular multidisciplinary medication reviews are essential to enhance safety and therapeutic outcomes. As the world’s population ages, many older adults develop multiple health conditions that require taking several different medications at once. A new study in Malta revealed that 94% of residents in state-run community care homes were exposed to this practice, known as polypharmacy. Researchers examined medical files from four facilities to identify risky drug patterns among residents. They discovered that nearly one-fifth of the prescriptions analyzed were actually inappropriate for the patients' specific needs. Many study participants were taking drugs aimed at reducing stomach acid, water pills, and antipsychotics for too long. Meanwhile, other patients lacked essential treatments for serious heart and lung conditions. The most common drug combination was found to increase the risk of sudden drops in blood pressure, potentially leading to increased fall-related injuries. To fix these issues, the study calls for immediate clinical action to protect resident safety. It is recommended that care homes use standardized checklists and regular team reviews to ensure every resident receives the safest and most effective care possible.