Real-life dosing conditions in older adults and geriatric patients in Poland - An international questionnaire study to investigate the regional differences in drug intake behaviour in the older population.

Older people represent approximately 20% of the Polish population and are the primary population using medications. Behaviours connected with drug intake (such as dosage form modifications, type and amount of fluid and/or food accompanying administration) are crucial for drug efficacy and avoidance of adverse effects. The presented study had three research aims; firstly, to investigate the real-life drug administration process among older adults and geriatric patients in Poland. Secondly, to compare data from Poland with data from a previous study performed in Germany, based on the same questionnaire. Thirdly, to discuss the potential influence of dosing conditions on the behaviour of orally administered medications (especially drug absorption) and identify potential problems with drug intake itself. This questionnaire-based study was conducted in the form of in-person interviews led by research team members. In this study, 174 participants, aged 65-94 years old were recruited from three settings in the Pomeranian region of Poland: home setting, nursing home and hospital. In Poland, the preferred method of medication intake was administration of all medications simultaneously. Patients were taking their medications most often directly after food ingestion, which commonly consisted of bread with butter, ham or cheese and black tea. The most common fluid for drug administration was either a few sips or 100 mL of non-carbonated water (mineral or tap water) as well as black tea. Dividing tablets (defined as splitting tablets in parts) was the most common modification. There were many similarities in the way of administering medications between the Polish and German older populations, specifically the use of non-carbonated water as the most common fluid for medication intake as well as bread as the main ingredient of breakfast and dinner. The biggest difference between populations was the choice of black tea as a medium for medication intake much more frequently in the Polish population than the German (who also preferred mint, herbal and fruit teas), and using a smaller volume of fluid. The presented study gives insight into the medication intake process in the older Polish population from the Pomeranian region in North Poland in comparison to the German population from the Pomeranian region in North East Germany. The results may help to identify factors that could decrease medication efficacy and safety, which is crucial, especially for the older population. Furthermore, the collected data may be useful for in vitro or in silico simulations to enhance drug development based on real-life data.