Abstract: Objective To explore the current status and influencing factors of polypharmacy and potentially inappropriate medication(PIM)among patients with multimorbidity in rural areas, and to compare the differences and applicability of the 2023 Beers Criteria(hereinafter referred to as the "Beers Criteria")and the Chinese Criteria for Potentially Inappropriate Medications in Older Adults(2017 Edition)(hereinafter referred to as the "Chinese Criteria")in PIM evaluation, with the aim of providing evidence for reducing PIM incidence in this population. Methods A multi-stage random sampling method was used to select 531 multimorbid patients from 16 villages in Shandong Province. Medication use was investigated via questionnaire surveys, and PIM was assessed using both the Beers Criteria and the Chinese Criteria. Multivariate Logistic regression was performed to identify risk factors for PIM, and the Kappa test was employed to evaluate consistency between the two criteria. Results According to the Beers Criteria, 390 patients had PIM, while the Chinese Criteria identified 312 cases. Both criteria highlighted high-risk medications such as reserpine, aspirin, and nifedipine. Multivariate Logistic regression revealed that gender and the number of medications were significant influencing factors for PIM(P<0.05). The consistency coefficient(Kappa)between the two criteria was 0.179; however, after incorporating reserpine into the Beers Criteria, the consistency improved to 0.369. Conclusion PIM is prevalent among rural patients with multimorbidity in Shandong Province. We recommend combining both criteria in clinical practice to enhance PIM detection accuracy and establishing a systematic PIM identification framework for traditional Chinese patent medicines.

Key words: Rural area, Multiple chronic diseases, Potentially inappropriate medication, Beers standard