Abstract
Polypharmacy is a challenging issue in geriatrics. The aim of the study was to characterize correlates of polypharmacy in the PolSenior project. The PolSenior project, was a comprehensive survey in a large and longitudinal representative sample of thePolish older population. The project was conducted by the International Institute of Molecular and Cell Biology in Warsaw between 2008 and 2011. All medications consumed during the week preceding the survey were evaluated for each participant (n = 4793, including 2314 females (48.3%)). Thereafter, the percentage of those with polypharmacy (at least 5 medications) and excessive polypharmacy (at least 10 medications) was calculated, and their correlates were determined. The average number of medications used by participants was 5.1 ± 3.6, and was higher in females than in males (5.5 ± 3.5 vs. 4.8 ± 3.5; p < 0.001). Polypharmacy characterized 2650 participants (55.3%) and excessive polypharmacy—532 of them (11.1%). The independent correlates associated withpolypharmacy were: age over 70 years, female sex, higher than primary education, living in an urban area, comorbidities, any hospitalization during past five years, and visiting general practicioners at least yearly. As for correlates with excessive polypharmacy, they were: age 80–84 years, female sex, living in an urban area, diagnosis of at least four chronic diseases, and at least two hospitalizations in the last five years. This study serves as a starting place to understand patient characteristics associated with polypharmacy, excessive polypharmacy, and identify targeted interventions.
Highlights
Multimorbidity is highly prevalent in older adults [1] and is typically accompanied by multiple drug regimens, described as polypharmacy
In the SHARE project, based on a representative sample of community-based older populations from 17 European countries, the prevalence of concurrent use of at least five medications ranged from 26.3% to 39.9% [28]
The methodology of data collection used in the SHARE project justifies the differences observed in relation to our study, because the SHARE participants may not have included all of the pharmaceutical preparations consumed
Summary
Multimorbidity is highly prevalent in older adults [1] and is typically accompanied by multiple drug regimens, described as polypharmacy. The prevalence was almost half as common (44%) in a registry-based prospective cohort study from Sweden, even though polypharmacy was defined as concurrent use of five or more medications (versus six in the Korean study) [4]. Despite these differences, the prevalence of polypharmacy generally increases over time. The authors of this study stated that the prevalence of polypharmacy and excessive polypharmacy increased radically with age and peaked up to 79.6% and 36.4% in individuals aged 90 and above, respectively These upward trends in polypharmacy may have many unpredictable effects [7]. It was shown that medication adherence is negatively associated with greater number of mediactions [9]
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