Patterns of use of medications, herbal products and nutritional supplements and polypharmacy associating factors in Palestinian geriatric patients

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Journal Title, Volume, Page: 
European Geriatric Medicine
Year of Publication: 
S.H. Zyoud, A.B. Abd-Alhafez, A.O. Hussein, I.S. Abu-Shehab, S.W. Al-Jabi, W.M. Sweileh
Preferred Abstract (Original): 



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.


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.


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.


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.


  • Elderly; 
  • Herbal products; 
  • Nutritional supplements; 
  • Polypharmacy
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