Polypharmacy and Psychological Distress May Be Associated in African American Adults.

Shervin Assari,Mohsen Bazargan

doi:10.3390/pharmacy7010014

Abstract

Background: Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies, however, have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, and stress—in African Americans. Aims: In a national sample of African Americans in the US, this study investigated the association between polypharmacy and psychological distress. Methods: The National Survey of American Life (NSAL, 2003) included 3570 African American adults who were 18 years or over. This number was composed of 2299 women and 1271 men. Polypharmacy (using ≥ 5 medications) and hyper-polypharmacy (using ≥ 10 medications) were the independent variables. Psychological distress was the dependent variable. Age, gender, socioeconomic status (education attainment, income, employment, and marital status), health care access (insurance status and usual place of care), and health status (multimorbidity and psychiatric disorders) were the covariates. Linear multivariable regression was applied to perform the data analysis. Results: Both polypharmacy and hyper-polypharmacy were associated with psychological distress. This association was significant after controlling for all the covariates. Conclusions: African Americans with polypharmacy, particularly those with hyper-polypharmacy, are experiencing higher levels of psychological distress, which itself is a known risk factor for poor adherence to medications. There is a need for a comprehensive evaluation of medications as well as screening for psychopathology in African Americans with multiple medical conditions.

Highlights

Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy
We found a link between polypharmacy and distress beyond the effects of gender on both polypharmacy and psychological distress
We found a link between polypharmacy and psychological distress in a nationally representative sample of African Americans for the first time

Summary

Introduction

Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, and stress—in African Americans. Aims: In a national sample of African Americans in the US, this study investigated the association between polypharmacy and psychological distress. Results: Both polypharmacy and hyper-polypharmacy were associated with psychological distress. As polypharmacy increases the risk of drug–drug interactions and reduces adherence to the necessary medications [3,4], it is being considered as a suggestive and probable indicator of the inappropriate use of medications [5,6,7]. Pharmacy 2019, 7, 14 care system, and society [10] This effect is mainly because polypharmacy reduces medication adherence and increases inappropriate drug use and adverse drug reactions [11,12]. The negative consequences of polypharmacy are high in older adults, who are more fragile and experience age-related physiological decline [16]

Methods

Discussion

Conclusion