Abstract
ObjectivePolypharmacy and inappropriate prescribing are overlooked issues in Bulgaria. We aimed at collecting and analyzing global literature on the most prevalent risk factors and investigating what they could reveal about current practice.Materials and MethodsA systematic narrative review and meta-analysis was conducted on the topic, investigating the prevalence of polypharmacy, odds of potentially inappropriate medications (PIMs) due to polypharmacy, and the likelihood of developing a drug-related problem (DRP) due to PIMs. The results were then related to current demographic statistics to estimate the potential impact on Bulgarian elderly patients.ResultsThe prevalence of polypharmacy was estimated at 41% in elderly populations. The odds of a potentially inappropriate medication being prescribed were 2.095, with an expected 30.84% of those leading to a DRP. These numbers indicated that the expected Bulgarian elderly with polypharmacy should be 709,676 with 212,903 cases of DRPs.ConclusionGlobal polypharmacy rates seem to be on the rise, with an expected increase in DRPs.
Highlights
Polypharmacy refers to the use of multiple medications in a patient, with the most common class of patients utilizing multiple medicines being older adults with multimorbidity
Factors, Affecting the Likelihood of a drug-related problems (DRPs) or Potentially inappropriate medication (PIM) Among the reviewed articles, four in total focused on the prevalence and causes of DRPs [22, 32–34]
Global polypharmacy rates seem to be on the rise, with expected increases in DRPs associated with it
Summary
Polypharmacy refers to the use of multiple medications in a patient, with the most common class of patients utilizing multiple medicines being older adults with multimorbidity. Polypharmacy has seen increased interest, due to the increased consumption of medicines leading to clinical issues [1]. Despite multiple definitions of what polypharmacy is—both numerical definitions of the number of drugs, and descriptive definition of polypharmacy, the most commonly used definition is the application of five or more medicines, which is used as the working definition in this article [2]. The term may be escalated or de-escalated to include the following three groups, which we have accepted for the article: a. Excessive polypharmacy (EPP): ten or more different drugs. B. Polypharmacy (PP): the use of five to nine drugs. C. No polypharmacy: taking four or fewer drugs [3]
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