The Psychological Aspect of Polypharmacy Among Patients with Chronic Diseases. A Case Control Study about The Impact of Polypharmacy Regime Amongst Patients in Kurdistan Region of Iraq

Abstract

Background: Patients on Polypharmacy due to a chronic illness are at a higher risk of developing some form of negative psychological outcome as a result of their disease. This study aims to determine the impact of Polypharmacy on the Psychological aspect of patients living with a chronic disease. Method: A case-control study conducted among patients in an outpatient clinic of an Internist (July 1st to September 1st, of 2021) in the city of Erbil, Iraq. Data was extracted from a self-assessed questioner amongst 200 patients divided into a Polypharmacy (case group) and non-Polypharmacy group (Control group). Polypharmacy, being defined as the use of five or more medication. A ‘Hospital Anxiety and Depression Scale’ (HADS) was used to determine the presence of symptoms of depression and/or anxiety. Results: A totally of 200 patients were included in the study. Of these 100 participants were from the non-polypharmacy group while the remaining 100 were from the polypharmacy group. Of these, depression among non-polypharmacy group (control) participants were 11% while 76% were found to be non-cases of depression. Compared to that, 31% of the polypharmacy group had depression while 51% were non-cases for depression. Also. the prevalence of depression and anxiety was increasing with an increase in number of medications taken by the patients. Depression was present in 11% of patients who took 4 or less medications while the prevalence increased to 21.1%, 34.9% and 42.1% in patients who took five, six to eight, and more than nine medications, respectively Conclusion: There is a significant link between polypharmacy and psychological distress in patients with chronic diseases with a focus on depression and anxiety. Healthcare providers can help in detecting polypharmacy and in providing recommendations for simplifying medication regimes and reducing the outcomes of chronic diseases.