Abstract
BackgroundWhile there are advances in medicine and pharmaceutical care, the burden of medication use has also grown with polypharmacy. In this regard, cardiovascular patients are subjected to polypharmacy for a longer period.ObjectiveThe present study aimed to assess the prevalence and predictors of polypharmacy in cardiovascular outpatients attending the University of Gondar Comprehensive specialized hospital, northwest Ethiopia.MethodsA hospital-based cross-sectional study was employed at the University of Gondar Comprehensive Specialized Hospital from March 30 –May 30, 2019. The unique medical registration number of 424 patients was selected by using systematic random sampling to trace the medical chart and followed with an interview to explore the factors related to polypharmacy. All the Statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 22. Bivariable and multivariable logistic regressions were used to identify the predictors of polypharmacy in cardiovascular patients.ResultThe mean age of the respondents was 56.83 ± 15.27 years. The mean number of medications per patient was 3.3±1.6. The prevalence of polypharmacy was 24.8% in cardiovascular outpatients while cardiovascular specific polypharmacy was 9.2%. Elderly (aged ≥ 65 years and above) patients were nearly two times more likely to had polypharmacy prescriptions with AOR: 1.97; 95% CI: 1.08–3.61; p = 0.027. Patients with abnormal weight (underweight AOR: 4.51; 95% CI: 1.42–14.30; p = 0.010, overweight AOR: 3.78; 95% CI: 1.83–7.83; p<0.001 and obese AOR: 5.1; 95% CI: 2.04–12.75 p<0.001) are more likely to have polypharmacy. Having a family history of CVD increase the likelihood of polypharmacy more than double; AOR: 2.40; 95% CI: 1.17–4.93; p = 0.017. A unit increase in Charlson comorbidity index score resulted in a nearly threefold likelihood of polypharmacy with AOR: 2.83; 95% CI 1.91–3.89; p<0.001.ConclusionOne out of four cardiovascular patients attending the outpatient clinic was on polypharmacy. The elderly age, abnormal body mass index (non-normal weight), family history of cardiovascular diseases and increasing Charlson morbidity index were the predictors of polypharmacy in cardiovascular patients. Clinicians should ensure the relevance of all prescribed medications and pharmaceutical care targeting at the prevention of inappropriate polypharmacy would be pivotal to reduce polypharmacy associated burdens.
Highlights
There is no universally agreed definition for polypharmacy, but it has been identified as the regular intake of five or more medicines in most of the literatures [1,2,3]
One out of four cardiovascular patients attending the outpatient clinic was on polypharmacy
The elderly age, abnormal body mass index, family history of cardiovascular diseases and increasing Charlson morbidity index were the predictors of polypharmacy in cardiovascular patients
Summary
There is no universally agreed definition for polypharmacy, but it has been identified as the regular intake of five or more medicines in most of the literatures [1,2,3]. Polypharmacy was known for its highest prevalence in the elderly population as consistently reported in available literature Despite this fact, two-thirds of all polypharmacy occurred in those aged less than 70 years old [7]. Two-thirds of all polypharmacy occurred in those aged less than 70 years old [7] This becomes more vivid in cardiovascular patients due to the complexity of the disease nature and multimorbid vulnerability which may lead to multiple medications. While there are advances in medicine and pharmaceutical care, the burden of medication use has grown with polypharmacy. In this regard, cardiovascular patients are subjected to polypharmacy for a longer period
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