Abstract
ObjectivesPolypharmacy is a problem of growing interest in geriatrics with the increase in drug consumption in recent years, is defined according to the WHO criteria as the, ‘‘concurrent use of five or more different prescription medication”. We investigated the clinical characteristics of polypharmacy and identified the effects of polypharmacy on clinical outcome among patients aged 80+ admitted to Chinese PLA general hospital.MethodsOlder men aged ≥80 years (n = 1562) were included in this study. The included participants attended a structured clinical examination and an interview carried out by a geriatrician and trained nurses. A follow-up survey in 2014 was carried out on survivors in the same way as in 2009. The clinical outcome measured were adverse drug reactions, falls, frailty, disability, cognitive impairment, mortality. The association between polypharmacy and clinical outcome was assessed by logistic regression.ResultsThe mean (range) age of the included participants was 85.2 (80–104) years. Medication exposure was reported by 100% of the population. Mean number of medications reported in this population was 9.56±5.68. The prevalence of polypharmacy (≥6 medications) in the present study was 70%. At the time of the follow-up survey, an increase in the number of taken medicines had occurred among half of the survivors. The risk of different outcomes in relation to number of medications rises significantly, the odds ratios were 1.21 (95% confidence interval [CI]1.17–1.28) for adverse drug reactions, 1.18 (95% CI 1.10–1.26) for falls, 1.16 (95% CI 1.09–1.24) for disability, and 1.19 (95% CI 1.12–1.23) for mortality. There was no association between increasing number of medications and cognitive impairment.ConclusionsOur study demonstrates that polypharmacy is very common in the very old patients, and observed that number of medications was a factor associated with difference clinical outcome independently of the age, type of medications prescribed and accompanied comorbidities.
Highlights
Population ageing is an increasing worldwide phenomenon [1]that means higher demands on health care, including the use of medications
Medication exposure was reported by 100% of the population
The risk of different outcomes in relation to number of medications rises significantly, the odds ratios were 1.21 (95% confidence interval [CI]1.17–1.28) for adverse drug reactions, 1.18 for falls, 1.16 for disability, and 1.19 for mortality
Summary
Population ageing is an increasing worldwide phenomenon [1]that means higher demands on health care, including the use of medications. Several previous studies have reported that polypharmacy is associated with the increased occurrence of inappropriate medication, drug-drug interactions, adverse drug reactions[6,7,8], and poorer health outcomes such as functional impairment, malnutrition, falls, fractures, and hospitalization [9,10,11,12,13]. There is an evidence on the association of polypharmacy with adverse outcomes in older adults, studies examining polypharmacy in oldest old patients in China are limited. The objective of the present study is to identify effects of polypharmacy on clinical outcome among patients aged 80+ admitted to our hospital
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