Abstract
BackgroundInappropriate medication use among individuals with depressive disorders (DD) is a rising public health challenge. We aimed to investigate the polypharmacy and its determinants among individuals with DD in a less developed region, and evaluate the pattern of medication use in this population.MethodsData was extracted from Pars Cohort Study (PCS) between 2016 and 2019. Participants were asked to bring all the medication they were using regularly, and history of DD during the last 12 months prior to study was obtained. The Anatomical Therapeutic Chemical classification was applied and polypharmacy was defined as concurrent use of five or more medications. Logistic regression models were developed to estimate the associations between polypharmacy and DD, adjusted for relevant covariates. The prevalence of consumption of each drug class was estimated among males, females, and elders. Logistic regression was applied and the adjusted odds ratio (OR) and its 95% confidence interval (CI) were estimated.ResultsA total of 9264 participants with a mean age of 52.6 (SD: 9.7) were enrolled. The prevalence of polypharmacy was 22.6% [95% CI (20.7–24.6)]. The most common drug classes were genitourinary system (55.4%) and nervous system (29.1%) medication, respectively. Recent history of DD was reported among 19.4% (n = 1795) participants, the majority of whom were females. Factors associated with polypharmacy include female gender (OR: 1.51), Fars ethnicity (OR: 1.52), lower physical activity (OR: 1.74), and higher socioeconomic status (OR: 1.40). The prevalence of antidepressant use among males was higher than females (P < 0.001).ConclusionThe prevalence of polypharmacy is high among patients with a recent history of depressive disorder. Females, individuals with higher socioeconomic status and lower physical activity, and those who use tobacco are more likely to be polymedicated. Surveillance measures need to be established to monitor the patterns of medication use among individuals with depressive disorders.
Highlights
Polypharmacy is a growing public health global challenge [1]
Surveillance measures need to be established to monitor the patterns of medication use among individuals with depressive disorders
Inspired by the fact that the polypharmacy among nonelderly people with depression is not routed in a similar list of risk factors associated with the polypharmacy in people without the DD, or in elderly individuals with or without the DD, we aimed to investigate the correlations of the polypharmacy in a population-based sample of patients with a recent history of the DD
Summary
Polypharmacy is a growing public health global challenge [1]. Polypharmacy may be necessary and sometimes inevitable, it may be an evidence of inappropriate medication use in a considerable proportion of patients suffering from it [1, 2]. Polypharmacy is a multifactorial iatrogenic condition but not a single-cause phenomenon. It may be a result of healthcare system-related, contextual factors and patientrelated factors. The contextual factors consist of inappropriate interaction between the health professionals, absence of effective strategies to prevent inappropriate polypharmacy, allowed direct-to-consumer marketing, the medicalization of everyday life, publicly funded healthcare, and culture of single-condition guidelinebased prescribing. Inappropriate medication use among individuals with depressive disorders (DD) is a rising public health challenge. We aimed to investigate the polypharmacy and its determinants among individuals with DD in a less developed region, and evaluate the pattern of medication use in this population
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