The burden of polypharmacy and potentially inappropriate medication in Nigeria: a clarion call for deprescribing practice

Abstract

Abstract Background Polypharmacy and potentially inappropriate medications (PIMs) could cause adverse drug events leading to poor health outcomes. This burden is addressed through deprescribing practice. However, data on deprescribing practices are lacking in Nigeria, where the healthcare systems are fragile. Aim This review aimed to summarise the literature on the burden of polypharmacy and PIMs and identify the need for deprescribing practice in Nigeria. Method A systematic search of the literature was conducted on MEDLINE through PubMed (Public Medline), Google Scholar, and a manual search of included articles to identify information on deprescribing, polypharmacy, and PIMs in Nigeria from the inception of the database to date. Relevant information from the articles was summarised and presented as subsections in the manuscript. Results In this review, we reported the burden of polypharmacy, PIMs, and the need for deprescribing practice in Nigeria. The estimated prevalence of polypharmacy was up to 23.8% among older patients with chronic disorders. Polypharmacy and PIMs have been reported to be a significant cause of medication non-adherence, drug addiction, drug interactions, adverse drug reactions, hospitalisation, morbidity, and mortality. Thus, there is the need to consider deprescription practice in the country. Conclusion This review revealed that polypharmacy and PIMs are common in Nigeria. Therefore, there is a need for deprescribing practice to improve drug safety in the country. This could be achieved through patient education, increasing awareness of deprescribing practice among the healthcare professionals, and ensuring adherence to the core prescribing indicators of the World Health Organization (WHO) and National Standard Treatment Guidelines.