An overview of prevalence, determinants and health outcomes of polypharmacy

Khezrian, Mina; McNeil, Christopher J.; Murray, Alison; Myint, Phyo Kyaw

doi:10.1177/2042098620933741

Cited by 235 publications

(285 citation statements)

References 53 publications

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“…The prevalence of polypharmacy found in the literature greatly varies. It ranges from around 4% to about 96.5% depending on the age group, definition, healthcare setting and region [7,11]. A cross-sectional analysis [43] from "wave 6" of the Survey of Health, Ageing, and Retirement in Europe (SHARE) database including data from 34,232 participants (mean age: 75.1 ± 7.2 years) revealed that the prevalence of polypharmacy, defined as the concurrent use of five or more medications, in older community-dwelling older adults (aged 65 years or more) ranges from 26.3 to 39.9% across 17 European countries plus Israel [43].…”

Section: Epidemiologymentioning

confidence: 99%

Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

2021

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Background The number of older adults has been constantly growing around the globe. Consequently, multimorbidity and related polypharmacy have become an increasing problem. In the absence of an accepted agreement on the definition of polypharmacy, data on its prevalence in various studies are not easily comparable. Besides, the evidence on the potential adverse clinical outcomes related to polypharmacy is limited though polypharmacy has been linked to numerous adverse clinical outcomes. This narrative review aims to find and summarize recent publications on definitions, epidemiology and clinical consequences of polypharmacy. Methods The MEDLINE database was used to identify recent publications on the definition, prevalence and clinical consequences of polypharmacy using their respective common terms and their variations. Systematic reviews and original studies published between 2015 and 2020 were included. Results One hundred and forty-three definitions of polypharmacy and associated terms were found. Most of them are numerical definitions. Its prevalence ranges from 4% among community-dwelling older people to over 96.5% in hospitalized patients. In addition, numerous adverse clinical outcomes were associated with polypharmacy. Conclusion The term polypharmacy is imprecise, and its definition is yet subject to an ongoing debate. The clinically oriented definitions of polypharmacy found in this review such as appropriate or necessary polypharmacy are more useful and relevant. Regardless of the definition, polypharmacy is highly prevalent in older adults, particularly in nursing home residents and hospitalized patients. Approaches to increase the appropriateness of polypharmacy can improve clinical outcomes in older adults.

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Section: Epidemiologymentioning

confidence: 99%

Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

2021

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“…172 Appropriate Polypharmacy' and Medicine Safety During COVID Polypharmacy is one of the most significant prescribing challenges within all health care settings worldwide. 13,184,185 According to WHO: Health care interventions are intended to benefit patients, but they can also cause harm. Every year, a significant number of patients are harmed or die because of unsafe health care, resulting in a high public health burden worldwide.…”

Section: Deprescribing As One Strategy To Reduce Inappropriate Polyphmentioning

confidence: 99%

<p>The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications</p>

Rahman¹,

Singh²,

Dhingra³

et al. 2020

TCRM

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COVID-19 pandemic is inducing acute respiratory distress syndrome, multiorgan failure, and eventual death. Respiratory failure is the leading cause of mortality in the elderly population with pre-existing medical conditions. This group is particularly vulnerable to infections due to a declined immune system, comorbidities, geriatric syndrome, and potentially inappropriate polypharmacy. These conditions make the elderly population more susceptible to the harmful effects of medications and the deleterious consequences of infections, including MERS-CoV, SARS-CoV, and SARS-CoV-2. Chronic diseases among elderlies, including respiratory diseases, hypertension, diabetes, and coronary heart diseases, present a significant challenge for healthcare professionals. To comply with the clinical guidelines, the practitioner may prescribe a complex medication regimen that adds up to the burden of pre-existing treatment, potentially inducing adverse drug reactions and leading to harmful side-effects. Consequently, the geriatric population is at increased risk of falls, frailty, and dependence that enhances their susceptibility to morbidity and mortality due to SARS-CoV-2 respiratory syndrome, particularly interstitial pneumonia. The major challenge resides in the detection of infection that may present as atypical manifestations in this age group. Healthy aging can be possible with adequate preventive measures and appropriate medication regimen and follow-up. Adherence to the guidelines and recommendations of WHO, CDC, and other national/regional/international agencies can reduce the risks of SARS-CoV-2 infection. Better training programs are needed to enhance the skill of health care professionals and patient's caregivers. This review explains the public health implications associated with polypharmacy on the geriatric population with pre-existing comorbidities during the COVID-19 pandemic.

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“…Polypharmacy is a term describing a scenario in which multiple medicines are prescribed to the same patient. Since the term has not been provided with one standard definition, it is most often described as concomitant use of five or more drugs (Masnoon et al, 2017;Khezrian et al, 2020). Of course, polypharmacy is not always a wrong strategy as more complex patients may benefit from what is referred to as 'appropriate polypharmacy' (Hughes, 2020).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Age Structure of Polypharmacy in Poland: Results of the Analysis of the National Real-World Database of 38 Million Citizens

Kardas

Urbański²,

Lichwierowicz³

et al. 2021

Front. Pharmacol.

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Introduction: Polypharmacy is a risk factor for adverse health outcomes, higher use of medical services and additional costs. The problem has gained attention as a consequence of aging and related multimorbidity. Therefore, there is an urgent need to adopt effective interventions aimed at reducing its burden. In order to achieve this, in-depth understanding of the prevalence of polypharmacy is required. Of particular interest is, however, assessing prevalence of polypharmacy in various age groups, to reach the right target for these interventions. So far, only limited data on polypharmacy among non-elderly individuals have been available.Aim of study: To assess overall prevalence of polypharmacy in Poland as well as its distribution in various age groups using real-world data.Methodology: A retrospective analysis of complete dispensation data of national payer organization for the years 2018–2019. The analyzed dataset included data on dispensation of reimbursed drugs, and exclusively for 2019, also non-reimbursed drugs. Polypharmacy was defined as dispensation of ≥5 prescription medications within six months.Results: In the analyzed national cohort of 38 million Polish citizens, the prevalence of polypharmacy was found to be 11.7% in 2018 and 11.6% in 2019. With age, the prevalence of polypharmacy increased, reaching the value of 56.0% in those aged 80+ in 2018, and 55.0% in 2019. Altogether, among those aged 65+, the polypharmacy was present in 43.1% in 2018, and 42.1% in 2019. In the youngest group of citizens, i.e., among those aged below 20 years, polypharmacy was found in 0.9%, and 0.8% in 2018 and 2019, respectively. Prevalence of polypharmacy, calculated for 2019 according to dispensation of five or more reimbursed and non-reimbursed drugs for the whole Polish population, was 21.8% for January-June, and 22.4% for July-December 2019. Among those aged 65+, the relevant numbers were 62.3%, and 62.9%, respectively.Conclusion: This study, being the first nationwide assessment of polypharmacy in Poland, confirmed its high prevalence. We found polypharmacy present in over one fifth of Polish society. Peaking in the elderly, polypharmacy occurred in each age group. These results lay the foundations for future interventions focused on reducing the scope of this problem in Poland.

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An overview of prevalence, determinants and health outcomes of polypharmacy

Cited by 235 publications

References 53 publications

Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences

<p>The Double Burden of the COVID-19 Pandemic and Polypharmacy on Geriatric Population – Public Health Implications</p>

Prevalence and Age Structure of Polypharmacy in Poland: Results of the Analysis of the National Real-World Database of 38 Million Citizens

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