An-Najah Staff

Abstract

Aims

This study aimed to estimate the prevalence of polypharmacy, polyherbacy and nutritional supplement use and to determine the factors affecting polypharmacy in geriatric patients from Palestine.

Methods

A prospective cross-sectional study of a group of hospitalised patients was carried out at Al-Wattani governmental hospital, Nablus, Palestine. This was a descriptive and comparative study that involved specially designed data collection forms. Some variables were collected by face-to-face interviews of a convenient sample of patients aged ≥ 65 years from May to November 2012. Participant demographics and information about the current use of prescribed medications, herbal products and nutritional supplements were collected. All collected data were analyzed using statistical package for social sciences (SPSS) version 15.0.

Results

Three hundred participants (mean age: 73.4 ± 7 years) were interviewed. The prevalence of polypharmacy (patients who take ≥ 5 medications) at hospital discharge was 51%. Eighty participants (26.7%) reported taking two or more herbal products (polyherbacy). Thirty-six participants (12.1%) reported taking two or more vitamins/mineral supplements. Binary logistic regression analysis revealed that patients living with their family (OR = 4.06; 95% CI = 1.39–11.83; P = 0.01), diabetes mellitus (OR = 2.67; 95% CI = 1.40–5.08;P = 0.003), heart failure (OR = 2.57; 95% CI = 1.25–5.28; P = 0.01), general weakness (OR = 3.82; 95% CI = 1.60–9.14; P = 0.003), and joint pain (OR = 8.02; 95% CI = 1.88–34.17; P = 0.005) were significantly associated with an increased risk of exposure to polypharmacy.

Conclusions

About half of elderly patients are exposed to polypharmacy at Al-Watani hospital. Also, a portion of geriatrics used herbal product and nutritional supplements. The factors that were associated with patient's exposure to polypharmacy were: living with family, diabetes mellitus, heart failure, general weakness, and joint pain. Interventions to reduce the high-level polypharmacy in the elderly during their stay in a government hospital in Palestine should focus more on patients with diabetes mellitus, heart failure, and joint pain.

Existing manuals do not provide clear specifications regarding the required crosswalk width under various pedestrian demand combinations and properties. Furthermore, they don’t offer any quantification regarding the effects of bi-directional flow and pedestrian flow composition upon capacity. This paper analyzes the effects of pedestrian age group and the interaction between bi-directional pedestrian flows on the capacity of signalized crosswalks. Three pedestrian age groups are defined: middle-age, pupils and elderly. A previous developed methodology for modeling pedestrian flows at signalized crosswalks is utilized to generate the fundamental diagrams of pedestrian flow. It is found that the maximum reduction in capacity occurs at roughly equal pedestrian flows from both sides of the crosswalk. Further, it is concluded that elderly pedestrians might cause a significant reduction in capacity up to 30%. © 2011 Published by Elsevier Ltd.