Association of potentially inappropriate prescribing with frailty among older adults with multimorbidity in Northwest Ethiopia

Abstract

Abstract Potentially inappropriate prescribing (PIP), which encompasses both potentially inappropriate medications (PIM), potential prescribing omissions (PPO), has been associated with frailty, but this relationship has not been explored in Northwest Ethiopia. A multicenter hospital-based cross-sectional study was conducted from March to June 2025 among hospitalized older adults with multimorbidity. PIP was assessed using the Screening Tool of Older Person’s Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatment (START) criteria version 3, while frailty was evaluated using the Clinical Frailty Scale (CFS). Binary logistic regression was performed to identify factors associated with PIM, PPO, and frailty. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and statistical significance was declared at P < 0.05. A total of 407 participants were included. The prevalence of PIP was 75.4% (95% CI, 71.5–79.4), and frailty was identified in 53.1% (95% CI, 48.2–58.0) of patients. Frailty was significantly associated with PIM, PPO, female gender, use of polypharmacy, and dependency in activities of daily living (ADL) in multivariable analysis. These findings highlight the importance of routine regular medication review and careful prescribing assessments in older adults with multimorbidity, particularly, those with frailty.